舒尼替尼对肾透明细胞癌不同转移灶疗效的探讨

Efficacy of Sunitinib for Different Metastatic Lesions of Renal Clear Cell Carcinoma

目的:探讨舒尼替尼对晚期肾癌患者不同转移灶的有效性。方法:晚期肾癌患者12例,男8例,女4例,平均年龄53岁。其中7例为根治性肾切除术后发现复发或转移,4例为发现肾癌时已不能完全切除所有病灶仅作患肾切除,1例肾穿刺证实为肾癌但未能行手术。病理诊断均为透明细胞癌。均以舒尼替尼作为一线药物,采用单一用药,口服50mg/d,每4周停2周乾7例,口服37.5 mg/d连续用药者5例,持续用药至肿瘤进展或出现不可耐受的不良反应。结果:平均服用舒尼替尼35周。部分缓解3例,疾病稳定6例,疾病进展3例,无完全缓解病例。客观反应率25.0%,疾病控制率75.0%。缓解病例多为局部复发及肺转移病灶,进展病例均为骨转移病灶。常见的不良包括手足皮肤反应、皮疹、食欲减退、疲劳乏力、骨髓抑制、味觉变化等。多为1～2级不良反应。结论:舒尼替尼治疗晚期肾癌患者有效,不良反应较轻,但其对不同器官组织转移灶的有效性可能存在一定的差异。

Objective：To evaluate the efficacy of Sunitinib for different metastatic lesions of patients with ad- vanced renal cell carcinoma. Methods：The clinical data of 12 patients with advanced renal cell carcinoma were reviewed. 8 were males and 4 were females, the average age was 53 years. Recurrence or metastasis was found in 7 patients after radical nephrectomy, 4 patients had metastasis before nephrectomy. Primary renal lesion of 1 patient could not be resected while the patient got renal biopsy. Pathological type of all patients was clear cell carcinoma. Sunitinib was used as first-line treatment. 7 patients took 50 mg orally once daily for 4 weeks, followed by 2 weeks off, and 5 patients took 37.5 mg daily continuously, until intolerance or disease progression occurred. Results：The average treatment time was 35 weeks. CR 0 case, PR 3 cases, SD 6 cases, PD 3 cases. The overall oh jeetive response rate and disease control rate were 25.0% and 75.0G. Remissions were almost reached by patients with local recurrence or pulmonary metastasis. Progress occurred in 2 patients with bone metastasis. The common side effects included hand-foot skin reaction, rash, loss of appetite, lassitude, arrest of bone marrow, vomiting, etc. Most side effects were grade 1or 2. Conclusions： Sunitinib has definitive efficacy for patients with advanced renal cell carcinoma. With slight side effects. Different metastatic lesions may have different sensibility to sunitinib.