索拉非尼治疗晚期肾癌33例临床分析

Sorafenib in the treatment of advanced renal cell carcinoma （ analysis of 33 cases）

目的初步评价索拉非尼治疗晚期肾癌的疗效和不良反应。方法2007年5爿至2009年6月应用索拉非尼治疗转移性肾癌33例。男23例，女10例。年龄21～81岁，中位年龄54岁。其中透明细胞癌29例，乳头状细胞癌2例，嫌色细胞癌和透明混合嫌色细胞痛各1例。单一脏器转移18例，多脏器转移15例，至少具有1处可测量病灶。其中发现肾癌同时伴有转移4例，术后发现转移29例，术后1年以内发现转移15例，〉1年14例。曾接受免疫治疗和（或）化疗13例，索拉非尼一线治疗20例。口服索拉非尼400～600mg2次／d，直至肿瘤进展或出现不可耐受的不良反应。采用实体瘤疗效评价标准每8周评定1次。随访11～106周，中位随访时间29周。结果全组无完全缓解患者，部分缓解4例（12％），疾病稳定27例（82％），疾病进展2例（6％），无死亡病例。最常见的不良反应是手足皮肤反应28例（85％）、腹泻15例（46％）、皮疹14例（42％）、脱发12例（36％）、口腔炎及溃疡6例（18％）、高血压2例（9％），3级腹泻1例（3％），未见4级毒副反应。结论索拉非尼治疗晚期肾癌有效率12％，疾病控制率94％。不良反应较轻，大多数患者可以耐受。

Objective To investigate the efficacy and toxicity of sorafenib in the treatment of advanced renal cell carcinoma. Methods From May 2007 to JUN 2009, 33 patients with advanced renal cell carcinoma were given oral sorafenih 400 -600 mg twice daily. There were 23 males and 10 females in the study group. The pathological diagnosis of the primary tumors was clear cell carcinoma in 29 patients, papillary renal cell carcinoma in 2 patients, chromophobe renal cell carcinoma in l patient and chromophobe renal cell carcinoma mixed with clear renal cell carcinoma in 1 patient. Fifteen patients had multiple organ metastases and 18 patients had single organ metastasis. The median follow-up time was 29 weeks. Results Four （12%） patients achieved partial remission, 2 （6%） patients achieved progression disease, the remaining 27 （82%） patients achieved stable disease. Complete remission was not observed in the group. Two of the partial remission patients benefited on bone metastases. Common toxicities were skin reaction （85%） , diarrhea （46%） , erythra （42%） , alopecia （36%） , oral ulcer （18%） and hypertension （9%）. Conclusions Sorafenib could be effective in controlling tumor growth. The overall effectiveness was 12% , the disease control proportion was 94% in this group and its toxicity was relatively minor and well tolerated.