索拉非尼在晚期肾癌治疗中所致高血压及其处理  

Management of hypertension induced by sorafenib in advanced renal cell carcinoma

作　　者：杨琳[1] 丁英俊[2] 石磊[1] 于世英[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院肿瘤科,武汉430030 [2]华中科技大学同济医学院附属同济医院老年科,武汉430030

出　　处：《肿瘤》2012年第5期380-383,共4页Tumor

基　　金：湖北省自然科学基金资助项目(编号:2011CDB213)

摘　　要：目的:观察索拉非尼治疗晚期肾癌期间高血压的发生及其处理,评估高血压对索拉非尼疗效的预测作用。方法:对30例晚期肾癌患者给予索拉非尼治疗,观察不良反应高血压的发生情况,对高血压进行分级并采取相应的降压治疗措施,观察索拉非尼所致高血压对降压治疗的反应,并采用单因素分析评估高血压对索拉非尼疗效的预测作用。结果:30例晚期肾癌患者服用索拉非尼后,发生高血压的中位时间为15d(6～58d),高血压发生率为30.0%(9/30),其中大多数(8/9,88.9%)为1～2级。降压治疗后血压控制稳定,未出现高血压危象及相关心脏事件。无患者因严重高血压导致索拉非尼治疗减量或中断。发生高血压对索拉非尼疗效的预测无统计学意义(χ2=0.635,P=0.637)。结论:索拉非尼治疗晚期肾癌的高血压发生率较高,但以轻至中度为主,降压治疗效果较好。高血压对索拉非尼疗效无预测作用。Objective：To investigate the incidence and management of hypertension induced by sorafenib in patients with advanced renal cell carcinoma,and to evaluate the relationship between hypertension and the response to sorafenib.Methods：The incidence of blood pressure in 30 patients with advanced renal cell carcinoma treated with sorafenib was calculated and the severity of hypertension was classified as grade 1 to grade 5.The corresponding antihypertensive therapy was conducted and the change of blood pressure after treatment was observed.The predictive value of hypertension for the response to sorafenib was evaluated by using univariate analysis.Results：The median time from the initiation of sorafenib treatment to the occurrence of sorafenib-induced hypertension in 30 patients with advanced renal cell carcinoma was 15 d（range：6-58 d）.The incidence of sorafenib-induced hypertension was 30.0%（9/30）.In these 9 patients,most（88.9%） of them were classified as grade 1 to grade 2 of hypertension.The hypertension was controlled well after corresponding antihypertensive treatment.No serious cardiac events or hypertensive crisis were observed.The dose of sorafenib was not reduced or the sorafenib treatment was not interrupted due to the uncontrolled hypertension.Univariate analysis revealed that sorafenib-induced hypertension was not a significant predictor for the response to sorafenib（χ2=0.635,P=0.637）.Conclusion：The incidence of sorafenib-induced hypertension during the treatment of advanced renal cell carcinoma is high,but the severity of this hypertension is mostly mild or moderate,and the response to antihypertensive treatment is satisfying.The sorafenib-induced hypertension is not a predictor for the response to sorafenib.

关 键 词：肾肿瘤 高血压 靶向治疗 索拉非尼 

分 类 号：R737.11[医药卫生—肿瘤]