转移性肾癌的治疗进展

转移性肾癌是一种对于传统放、化疗较不敏感的不可治愈性疾病。虽然免疫治疗对部分患者具有一定疗效,但疗效通常并不持久,并且治疗可能导致严重的毒副作用。随着近年来对肾癌生物学及分子发病机制的加深了解,针对使用多种靶向治疗药物治疗肾癌的研究取得了可喜的成果。无论针对初治或以往治疗失败的患者,靶向治疗均显示出高于传统治疗的优越性。此外,治疗的耐受性非常良好,并不影响患者的生存质量。文章介绍了转移性肾癌的手术、免疫、化疗、放疗、靶向治疗等治疗的进展。

Surgery is the only curative treatment modality for renal cell carcinoma(RCC). However, approximately 30% of patients who undergo successful nephrectomy for RCC will develop metastatic recurrence. Effective treatment for recurrent or metastatic RCC is limited. It is known that conventional radiation therapy and chemotherapy are relatively ineffective for RCC patients with distant metastases. Although immune therapy with high dose interleukin can provide disease control for a portion of patients with advanced RCC, its therapeutic effect usually is not sustainable. In addition, substantial adverse effects and complications have limited the use of high dose interleukin treatment. Advances in the understanding at the molecular level of cancer have led to much progress in the development of anti-cancer agents, including drugs of targeted cancer therapy. Targeted therapy is not only effective in cancer treatment, but also has reduced adverse effects compared with conventional chemotherapy and immune therapy. Much progress in the treatment of advanced RCC by targeted therapy has been achieved in recent years. This article reviews the progress in surgery, immune therapy, chemotherapy, radiotherapy and targeted therapy in metastatic RCC.