靶向治疗肾癌并肾静脉癌栓后腹腔镜下根治性切除术的可行性研究  

Retroperitoneal laparoscopy surgery after targeted therapy for renal cell carcinoma with renal vein cancer embolus

作　　者：李尧[1] 徐丹枫[1] 任吉忠[1] 汪凯[1] 张东旭[1] 

机构地区：[1]第二军医大学附属长征医院泌尿外科,上海200003

出　　处：《临床泌尿外科杂志》2012年第9期641-643,共3页Journal of Clinical Urology

摘　　要：目的:分析及研究靶向药物治疗肾癌并肾静脉癌栓后腹腔镜治疗的可行性、有效性和安全性。方法:2010年12月～2012年2月对4例单侧肾癌并肾静脉癌栓(无远处及局部淋巴结转移)患者先行靶向药物治疗3～6个月,其中3例使用苹果酸舒尼替尼(索坦),1例使用甲苯磺酸索拉非尼(多吉美);对照靶向治疗前后影像学检查并相继行后腹腔镜下肾癌根治性切除术,其中1例行后腹腔镜下腔静脉阻断癌栓取出术。结果:4例患者手术均获得成功,无中转开放手术。4例患者术后继续常规剂量服用靶向药物,并每3个月复查胸部及肾脏CT。结论:外科手术与靶向药物相结合的治疗手段代表肾癌并肾静脉癌栓患者最佳的选择方案,因为单纯靶向药物和单纯外科手术已经无法满足预后及生存率的真正需求。Objective：To analyze the feasibility, efficiency and safety of the retroperitoneal laparoscopy opera- tion after targeted therapy for renal cancer with renal vein cancer embolus. Methods：From December 2010 to Feb- ruary 2012, 4 patients of unilateral renal cancer with renal vein cancer embolus （without distance and local lymph node metastasis） were treated with targeted drugs for 3-6 months first, 3 of the patients were treated with Sunitinib Malate while the other was treated with Sorafenib tosylate; retroperitoneal laparoscopic radical nephree- tomy after comparing the imaging examination of targeted therapy. Results：All the operations were completed une- ventfully without conversions to open surgery. One of the surgery was retroperitoneal laparoscopie inferior vena cava blocking and removing the cancer embolus. However, all the patients were treated with the targeted drugs in standard--dose after the surgery, and reexamine the chest and kidney CT in every 3 months. Conclusions： Some re- markable progress has been made in the targeted therapy for renal cancer in recent years, which it can ameliorate the tumor response rate and progression-free survival effectively. However, the cure for tumor is still unachiev- able. The best way for these patients is combine the surgical operation with targeted therapy. More specifically, surgical operation plays a significant role in renal cell carcinoma, but to the patients in advanced lesion or with re- nal vein cancer emholus only surgical treatment is unsufficient for the requirements of prognosis and surival rate. Nevertheless, the appropriate selection of patients and accurate grasp of the drugs indications are the prerequisites for treatment.

关 键 词：肾肿瘤 腔静脉癌栓 腹腔镜术 靶向药物治疗 

分 类 号：R737.11[医药卫生—肿瘤]