索拉非尼治疗转移性肾癌的疗效预测因素分析

Predictive factors of sorafenib in the treatment of metastatic renal cell carcinoma

目的探讨索拉非尼治疗转移性肾癌的疗效及预后预测因素。方法经病理确诊的转移性肾癌患者51例。口服索拉非尼治疗，同期联合或不联合干扰素、全身化疗，治疗2周期进行疗效评价，观察客观疗效，将其与临床特征等因素进行相关性分析，疗效相关性采用Х^2检验及Logistic回归分析分别进行单因素及多因素分析。结果51例患者中，客观反应率29．4%（95％可信区间为16．9％～41．9％），多因素分析显示单纯肺转移与客观反应率明显相关（P=0．021，HR=5．127）。结论索拉非尼治疗转移性肾癌有较好疗效，单纯肺转移是索拉非尼疗效的独立预测因素。

Objective To analyze the effect and related factors of sorafenib in the treatment of metastatic renal cell carcinoma（MRCC）, and identify the potential predictive factors of sorafenib response. Methods The data of 51 MRCC patients who received sorafenib therapy, with or without combination with interferon or chemotherapy were retrospectively reviewed. After two cycles of treatment, patients were evaluated for progression or response. Pearson Chi-square test and Logistic regression test were performed respectively as univariate and multivariate analyses of sorafenib response. Results The overall objective response rate was 29.4% （95 % confidence interval 16.9% to 41.9 %, with 1（2.0%） complete response and 14（27.4%） partial responses. Twenty-nine（56.9%） had stable disease, and 7（13.7%） had progression disease （PD）. Significant independent predictive factors associated with good response in multivariate analysis were lung metastasis only（P= 0. 021, HR= 5. 127）. Conclusions Sorafenib is effective in MRCC patients. Lung metastasis only is predictive factor in multivariate analysis for sorafenib response.