立体定向放射治疗配合靶向药物索拉非尼治疗复发及转移性肾细胞癌的疗效分析

Efficacy of stereotactic body radiation therapy with γ-knife combined with targeted drug sorafenib in treatment of recurrent and metastatic renal cell carcinoma

目的探讨γ-体部立体定向放射治疗(stereotactic body radiation therapy withγ-knife,γ-SBRT)配合靶向药物索拉非尼(sorafenib)治疗复发及转移性肾癌的效果。方法 2007-05至2009-05收治的肾癌术后复发及转移患者45例中,26例单纯行γ-SBRT,19例行γ-SBRT配合Sorafenib治疗,比较两组的有效率、局部控制率、生存率及生存质量改善情况。结果治疗后3个月总有效率为80.0%(36/45)。单纯γ-SBRT组的1年、2年局部控制率分别为42.3%(11/26)、19.2%(5/26);中位生存12个月;1年、2年生存率分别为46.2%、19.2%。γ-SBRT+Sorafenib组的1年、2年局部控制率分别为47.3%(18/19)、21.1%(4/19),中位生存18个月;1年、2年生存率分别为57.9%、26.3%。结论采用γ-体部立体定向放疗结合靶向药物索拉非尼对复发及转移性肾癌进行治疗效果较好,不良反应轻微,多数患者能耐受治疗。

Objective To study the efficacy of stereotactic radiation therapy with gamma - knife （ γ- SBRT） combined with targeted drug sorafenib in treatment of recurrent and metastatic renal cell carcinoma. Methods From May 2007 to May 2009, 45 patients with recurrent and metastatic renal cell carcinoma patients were admitted. 26 of them were treated with γ - SBRT alone and 19 cases treated with γ- SBRT with Sorafenib treatment. Results The total effective rate after three - month treatment was 80.0% （36/ 45 ）. The local control rate at 1, 2 years was 42.3% （ 11/26）, 19.2% （5/26） ,median survival 12 months, and the cumulative survival rate at 1, 2 years was 46.2 %, 19.2%, respectively in γ - SBRT group. The local control rate at 1, 2 years was 47.3% （ 18/ 19） and 21.1% （4/19） ,median survival 18 months, and the cumulative survival rate at 1,2 years was 57.9% and 26.3%, respectively inγ- SBRT ＋ sorafenib group. Conclusions The combination of stereotactic gamma - body radiation therapy with targeted drug sorafenib for treatment of recurrent and metastatic renal cell carcinoma is an effective treatment. Adverse reactions are mild, and most patients can tolerate the treatment.