肾癌治疗中索拉非尼相关性腹泻的临床观察  

Sorafenib-related diarrhea in renal cell carcinoma

作　　者：杨琳[1] 丁英俊[2] 魏瑶[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：《临床内科杂志》2012年第10期682-684,共3页Journal of Clinical Internal Medicine

基　　金：湖北省自然科学基金资助项目（2011CDB213）

摘　　要：目的观察索拉非尼治疗肾癌过程中腹泻的发生、治疗及其转归，探讨腹泻对索拉非尼疗效的预测作用。方法对肾癌患者给予索拉非尼治疗，观察腹泻的发生，并进行分级，对症治疗后观察其转归，采用单因素分析法评估腹泻对索拉非尼疗效的预测作用。结果33例肾癌患者采用索拉非尼治疗，腹泻发生的中位时间为13天（4～65天），发生率为33．3％（11／33），其中90．9％的患者为1—2级，对症治疗常可缓解。因腹泻导致索拉非尼减量1例，因腹泻终止索拉非尼治疗1例。索拉非尼的疗效在有或无腹泻发生的患者间比较，差异无统计学意义（P〉0．05）。结论索拉非尼治疗肾癌时，相关性腹泻的发生率较高，但多为轻、中度，对症治疗效果好。腹泻对索拉非尼疗效未能显示出预测作用。Objective To investigate the occurenee, management and consequence of sorafenib- related diarrhea in renal cell carcinoma, evaluate the association between diarrhea and the effect of sor- afenib. Methods The adverse event of diarrhea was observed in advanced renal cell carcinoma patients treated with sorafenib. Diarrhea was classified as grade 1 to grade 4 and was conducted corresponding management, the consequences of diarrhea after management and the association between diarrhea and the effect of sorafenib were investigated. Results 33 patients with advanced renal cell carcinoma received sorafenib treatment. The median time of sorafenib-related diarrhea occurrence was 13 days（4 days to 65 days）. The incidence rate was 33.3% （ 11 patients out of 33 ）. Of the 11 patients, most （90.9%） were classified as grade 1 to grade 2 and relieved well after treatment. 1 patient reduced the dose of sorafenib, and 1 patient terminated the treatment with sorafenib due to diarrhea intolerance. Univariate analysis re- vealed that sorafenib-induced diarrhea was not statistically significant for predicting the disease relief after sorafenib thrapy （ P 〉 0.05 ）. Conclusion In advanced renal cell carcinoma patients treated with sor- afenib,the incidence of treatment-induced diarrhea is high. Most of diarrhea symptom are mild to moder- ate, and response well to proper treatment. Diarrhea could not be a predictive factor for the effect of sor- afenib.

关 键 词：腹泻 索拉非尼 肾癌 靶向治疗 

分 类 号：R737.11[医药卫生—肿瘤]