舒尼替尼治疗晚期肾癌的临床疗效及安全性分析

摘要

Objective The purpose of this study is to explore the efficacy and safty of sunitinib in the treatment of metastatic renal cell cancer (mRCC).Methods A retrospective analysis was made for thirty-eight renal cell carcinoma patients,included twenty-seven male and eleven femal,who recived sunitinib as their first-line treatment or at relapse after initial treatment.Three patients were digonsed mRCC by puncture biopsy,thirty-four cases and one case respectively recived radical nephrectomy and partial nephrenectomy.Thirty-one ptients were diagnosed with clear cell cancer,three with papillary renal cell cancer,one with chromophobe renal cell cancer,three with moxed cell cancer.The majority metastatic sites consisted mostly of lung,lymph nodes,liver and bone,included single metastasis and multiple metastasis.Patients were started on sunitinib at a dose of 50 mg once a day for 4 weeks and then a gap of 2 weeks.Results Two patients (5.4%) achived complete response,five cases (13.1%) represented partial response,twenty-six cases (68.4%) developed stable disease and another five patients (13.1%) were progression disease.The following objective response rate performed for patients was 18.5% and disease control rate was 86.9%.The estimated mediman PFS was fifteen months and median OS was twenty-two months.The most common adverse events were hand-foot syndrome,fatigue,leukopenia,mucositis and hypertension.Conclusions The results of this study showed that sunitinib was efficacious and safe in the treatment of mRCC.Most adverse sides ranging from one to two degree were torlerable.%目的 初步探究舒尼替尼治疗晚期肾癌的疗效及安全性.方法 回顾性分析我科38例接受舒尼替尼治疗的晚期肾癌患者的临床资料.38例中男27例,女11例;行肾癌根治术34例,行保留肾单位手术1例,3例未行手术治疗.病理类型:透明细胞癌31例、乳头状癌3例、嫌色细胞癌1例、混合细胞癌3例.转移部位:肺21例、淋巴结9例、肝2例、骨5例、肾上腺2例、腔静脉10例、附件1例、腹膜后7例,其中单发转移20例(52.6%),多发转移18例(47.4%).舒尼替尼治疗采用标准的4/2方案:50 mg/d,口服,服4周停2周.结果 38例患者的疗效评价:完全缓解2例(5.4%)、部分缓解5例(13.1%)、疾病稳定26例(68.4%)、疾病进展5例(13.1%);客观缓解率18.5%,疾病控制率86.9%.中位无进展生存期为15个月,中位总生存期为22个月.常见不良反应有中性粒细胞降低、手足反应、口腔黏膜溃疡、皮肤黄染、毛发变白、腹泻、乏力和高血压.结论 舒尼替尼治疗晚期肾癌具有良好的效果,患者临床获益明显.虽然不良反应较多,但多为Ⅰ或Ⅱ级,在患者耐受范围之内.