舒尼替尼一线治疗转移性肾癌的效果及其多因素分析

Efficacy and the multivariate analysis of sunitinib as first-line treatment in patients with metastatic renal cell carcinoma

目的探讨舒尼替尼一线治疗转移性肾癌的疗效及其影响因素。方法回顾性分析自2008年8月至2015年12月北京大学肿瘤医院肾癌黑色素瘤科一线接受舒尼替尼治疗的转移性肾癌患者临床资料，并采用Kaplan－Meier法及Cox多因素回归方法分析其疗效相关因素。结果共有166例转移性肾癌患者一线接受舒尼替尼治疗，客观缓解率为31.9%，疾病控制率为84.3%，中位无进展生存为11.0个月（95% CI：9.0～14.0个月），中位总生存为28.0个月（95% CI：19.0～33.0个月）。多因素分析显示病理类型（透明细胞癌与非透明细胞癌，HR：1.889比2.353）、诊断至接受治疗时间间隔（〈1年与≥1年，HR：0.293比0.322），肿瘤转移器官数目（1个与≥1个，HR：2.360比4.351）是舒尼替尼一线治疗转移性肾癌无进展生存以及总生存的独立预后因素（P〈0.05）。结论转移性肾癌一线接受舒尼替尼的疗效与国内外报道的结果类似，透明细胞癌、诊断至治疗时间间隔〉1年以及单一器官转移的患者一线接受舒尼替尼治疗能够获得较好的无进展生存及总生存时间。

ObjectiveTo investigate the efficacy and the influence factors of sunitinib as first-line treatment in patients with metastatic renal cell carcinoma （mRCC）.MethodsClinical data of mRCC patients with sunitinib administered as the first line treatment from August 2008 to December 2015 were retrospectively reviewed. The efficacy and the influence factors of sunitinib treatment was analyzed using the Kaplan-Meier method and Cox proportional hazards models.ResultsIn all 166 patients who received sunitinib as first-line treatment, objective response rate was 31.9%, disease control rate was 84.3%. The median progression free survival （PFS） and overall survival （OS） were 11.0 months （95% CI： 9.0-14.0） and 28.0 months （95% CI： 19.0-33.0）, respectively. Multivariate analysis showed that pathological types （clear cell carcinoma vs non clear cell carcinoma, HR： 1.889 vs 2.353）, time from diagnosis to treatment（〈1 year vs ≥1 year, HR： 0.293 vs 0.322） and the number of metastatic sites （1 vs ≥1, HR： 2.360 vs 4.351） were the independent prognostic factors for PFS and OS （P〈0.05）.ConclusionsThe efficacy of sunitinib as first-line treatment in patients with metastatic renal cell carcinoma is similar to reports at home and abroad. The patients with renal clear cell carcinoma, time from diagnosis to treatment〉 1 year, and only one metastatic site would get better PFS and OS.