肾细胞癌的治疗进展  

Advances in the Treatment of Renal Cell Carcinoma

作　　者：李景勤[1] 

机构地区：[1]解放军第401医院,青岛266071

出　　处：《国外医药（抗生素分册）》2012年第3期131-137,共7页World Notes on Antibiotics

摘　　要：肾细胞癌(renal cell carcinoma,RCC)占成人恶性肿瘤的2%～3%,泌尿系恶性肿瘤的第二位,肾脏恶性肿瘤的80%～90%。随着影像技术的提高、检查的普及,早期肾癌检出率明显增加,但仍有20%～30%的肾癌患者在确诊时已有远处转移,超过40%的局限性肾癌患者术后发生复发或转移。根据肾脏肿瘤大小等自身特性及肿瘤侵袭范围等因素对患者预后的影响,2009年UICC/AJCC对TNM分期系统进行了明显修改,对选择RCC的治疗方式、评估预后有重要指导作用。手术是惟一可治愈的治疗手段,对于T1a期患者行肾部分切除术安全有效,对于T1b,保留肾单位手术和根治性肾切除术都是可选方案。对于远处转移的患者,减瘤手术作为内科系统治疗的辅助,效果确切。微创治疗、免疫治疗也取得了明显进步;放射治疗可用于mRCC患者以减轻痛苦和肾切除术后的局部复发。分子靶向药物改善了转移性肾癌患者的生存期和生活质量,成为mRCC的一线和二线治疗方案。Aproximately 2%-3% of all cancers are renal cell carcimoma. RCCs make up 80%-90% of all primary renal cancers in adults. The RCC can be diagnosed in earlier stage by using ultrasound （US）, computed tomography （CT）, Or magnetic resonance imaging （MRI）. Almost 20%-30% of the patients will have spread to other organs by the time they are diagnosed. 40%- 50% of the patients with local RCC will eventually recur or metastasize after be operated. The TNM stage classification system of 2009 version introduce significant changes, and it will guide the clinicans to select treating way and to estimate the prognosis. Resection is the only curative therapeutic approach for RCC. Nephron-sparing surgery （NSS） for localized RCC has an oncologic outcome to that of radical nephrectomy （RN）. The NSS is recommended for Tla and an option in Tlb tumours. The value of tumour nephrectomy is confirmed as a palliative and complementary systemic treatment in the metastatic renal cell carcinoma （mRCC）. Progresses are got in minimally invasive treatment and immunotherapy. Radiation therapy is useful for the patients with mRCC to reduce the pain. Molecular targeted therapy has been the main advances in the treatment of mRCC in recent years. Some of the targeting agents has become the first- or second-line therapic agents in USA and Europe.

关 键 词：肾细胞癌 TNM分期 靶向药物 治疗 

分 类 号：R73[医药卫生—肿瘤]