舒尼替尼在转移性肾癌中的应用

目的:探讨舒尼替尼在治疗转移性肾癌的疗效。方法:回顾6例使用舒尼替尼治疗转移性肾癌的临床资料。结果:本组患者6例,均为男性,年龄43～64岁,平均53.3岁,随访时间16～126周,平均56.3周。均行肾癌根治术,左侧4例,右侧2例。术后病理:5例为肾透明细胞癌,1例为混合性肾细胞癌,1例伴有肉瘤样变。病理分级:pT2～3N0～XM0～1。术后出现肺部转移6例,肝转移2例,骨转移3例,对侧肾脏转移2例,肾上腺转移1例,颅内转移1例。MSKCC评分0～2,ECOG评分1～3分。RECIST评价PR2例,其余4例疗效评价均为SD,没有CR病例。本组中位无疾病进展生存36周(95%CI29.6～42.4)。主要的不良反应为:疲乏、皮肤黄染、高血压、手足综合症,腹泻。结论:舒尼替尼不仅在mRCC一线治疗中有良好的疗效,同时在二线序贯治疗中也具有一定疗效。舒尼替尼治疗中的多数不良事件是可控、可逆、易于处理的。

Objective：To investigate the value of Sunitinib in the treatment of metastatic renal cell carcinoma（mRCC）. Methods Data of 6 cases of mRCCs treated with Sunitinib were reviewed retrospectively. Results：Six cases were available for analysis. All were male, the mean age was 53.3 （43 - 64） years old, mean follow - up was 56. 3 （ 16 - 126）weeks. All were undergone radical nephreetomy,4 at left side,and the other 2 at fight side. The pathological outcomes of primary tumors were ：5 renal clear cell carcinoma（ among them, one case accompanied with sarcoma change）, 1 mixed renal cell carcinoma （ consist of renal papillary carcinoma, renal clear cell carcinoma and renal spindle cell carcinoma ）. The pathologic grade was pT2 - 3N0 - XM0 - 1. T he metastatic sites of all the patients included 6 in lungs,3 in bone,2 in liver, 2 in contralateral kidneys, one in adrenal gland and one in brain. MSKCC score were 0 -2,ECOG score were 1 - 3. Two patients achieved PR, and the other d SD. Not CR case was available. The medial progress - free survival was 36 weeks, （95% CI 29.6 -42.4）. Common side effects were fatigue, hand -foot skin reaction, hypertension and diarrhea. Conclusions：Sunitinib is effective in the first -line treatment of mRCC as well as subsequently second line management. The most adverse events of Sunitinib are tolerable and control- lable.