舒尼替尼治疗晚期肾细胞癌的临床应用  

Clinlcal study of Sunitinib treatment for patients with advanced renal cell carcinoma

作　　者：石泓哲[1] 李长岭[1] 寿建忠[1] 肖振东[1] 肖则均[1] 田军[1] 王栋[1] 毕新刚[1] 管考鹏[1] 鲁力[1] 韩苏军[1] 温力[1] 关有彦[1] 

机构地区：[1]中国医学科学院肿瘤医院泌尿外科,北京100021

出　　处：《现代泌尿生殖肿瘤杂志》2011年第3期136-139,共4页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的评价舒尼替尼治疗晚期肾细胞癌的疗效和安全性。方法晚期肾细胞癌患者19例,男16例,女3例,中位年龄54(35～70)岁,随访时间2008年8月至2010年8月。原发肾脏病灶手术切除17例,穿刺病理证实2例。肾透明细胞癌17例,肾乳头状细胞癌2例。治疗方案:舒尼替尼50mg,每天1次,4/2方案,治疗4周停2周为1个治疗周期;至少每2个周期行影像学检查以确定疗效。结果随访时间3～22个月,可评价疗效18例,1例因患者经济情况停药。11例患者仍在接受舒尼替尼治疗,1例患者因肿瘤进展停药,6例患者因肿瘤进展死亡。中低危患者14例,中位疾病无进展时间(PFS)18个月,尚未测出中位生存时间。高危患者4例,中位PFS6个月,中位生存时间8.5个月。根据实体瘤评价标准(RECIST)进行疗效评价,共16例患者服药超过2个周期,2个周期评价部分缓解(PR)2例(12.5%);疾病稳定(SD)14例(87.5%)。共10例患者服药超过4个周期,4个周期PR1例(10.0%);SD6例(60.0%);疾病进展3例(30.0%)。常见不良反应包括手足皮肤反应、口腔溃疡、高血压、味觉改变、乏力、白细胞降低和血小板下降等,发生的Ⅲ级不良反应为手足反应2例(11.1%)、呕吐1例(5.5%)、白细胞降低1例(5.5%)、血小板降低1例(5.5%)、浮肿1例(5.5%)。通过对症支持及减量,不良反应可以控制并耐受。结论舒尼替尼治疗晚期肾细胞癌的控制率较高,大部分不良反应患者可耐受,部分严重不良反应需要医疗干预。Objective To evaluate the efficacy and safety of Sunitinib in the treatment of advanced renal cell carcinoma.Methods 19 patients with advanced renal cell carcinoma were enrolled from August 2008 to August 2010,male 16,female 3,median age 54 years（range 35 to 70 years）.17 patients received prior radical nephrectomy,2 patients received biopsy.17 patients were diagnosed as renal clear cell carcinoma,2 patients diagnosed as renal papillary cell carcinoma.Sunitinib monotherapy was administered in repeated 6-week cycles of daily oral 50 mg for 4 weeks,followed by 2 weeks off.CT or MRI scan was used to evaluate the efficacy every 2 cycles.Results Follow up were ranging 3 months to 22 months.18 patients could be evaluated the efficacy,1 patient cancelled for lacking of financial support.Till August 2008,11 patients were stable or partial response,1 patient developed progressive disease,6 patients died because of disease progression.Patients were classified according to the Memorial Sloan-Kettering Cancer Center（MSKCC）risk scoring system.14 patients were in low and intermediate risk group,the median progression free survival time was 18 months,the overall survival time has not archived.4 patients were in high risk group,the median progression free survival time was 6 months,the overall survival time was 8.5 months.16 patients were received treatment over 3 months（2 cycles）,2 patients（12.5%）achieved partial responses,14 patients（87.5%）demonstrated stable disease.10 patients were received treatment over 6 months（4 cycles）,1 patient（10.0%）achieved partial responses,6 patients（60.0%）demonstrated stable disease,3 patients（30.0%）developed progressive disease.The most commonly adverse events were hand-foot syndrome,mucositis,hypertension,dysgeusia,fatigue,neutropenia,and thrombocytopenia.Grade 3 adverse events included hand-foot syndrome,vomiting,neutropenia,thrombocytopenia,and facial edema.All adverse events were ameliorated by supportive treatment or dose reduction.Conclusions Sunitinib was

关 键 词：癌 肾细胞 肿瘤转移 舒尼替尼 

分 类 号：R737.11[医药卫生—肿瘤]