舒尼替尼相关性甲状腺功能减退与肾癌预后相关性分析  

Correlation of Sunitinib-induced hypothyroidism with prognosis in advanced renal cancer patients

作　　者：石泓哲[1] 李长岭[1] 寿建忠[1] 温力[1] 陈羲[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：《中华肿瘤防治杂志》2014年第7期528-531,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的：探讨舒尼替尼相关性甲状腺功能减退与晚期肾细胞癌的预后关系。方法：选取2009—04—30—2012-11—30中国医学科学院肿瘤医院晚期肾细胞癌患者38例，均行原发肾脏病灶手术切除，病理确诊为肾透明细胞癌。治疗方案：舒尼替尼50mg，1次／d，治疗4周停2周为1个周期；至少每2个周期行影像学检查确定疗效。每2～4周随诊甲状腺功能。结果：随访时间2～44个月，14例随访过程中出现甲状腺功能减退，24例未出现甲状腺功能减退。甲状腺功能减退组，完全缓解（CR）1例（7．14％），部分缓解（PR）5例（35．72％），疾病稳定（SD）8例（57．14％）。甲状腺功能正常组，CR1例（4．17％），PR2例（8．33％），SD18例（75．00％），疾病进展（PD）3例（12．50％）。甲状腺功能正常组中位疾病无进展时间9个月（95％CI：4．6～13．4），中位生存时间20个月（95％CI：4．9～35．1）。甲状腺功能减退组患者未达到中位疾病无进展时间和中位生存时间。常见的药物不良反应包括手足综合征、乏力、白细胞减少、血小板减少、口腔黏膜炎和高血压等，两组差异无统计学意义。结论：在舒尼替尼治疗中出现甲状腺功能减退的晚期肾细胞癌患者的中位无疾病进展时间较长，可能获得更长的中位生存时间。OBJECTIVE：To evaluate if hypothyroidism developed during sunitinib therapy in patients with advanced renal cell carcinoma is associated with a better prognosis. METHODS： Thirty-eight patients with advanced renal ceil carci-noma were enrolled from April 2009 to November 2012,including 27 males and 11 females with median age 50.5 years （range 31 to 76 years）. All patients received prior radical nephrectomy and were diagnosed as renal clear cell carcinoma. Sunitinib monotherapy was administered in repeated 6-week cycles of daily oral 50rag for 4 weeks, followed by 2 weeks off. CT or MR scan was used to evaluate the efficacy every 2 cycles. Thyroid function was assessed every 2--4 weeks dur-ing therapy. RESULTS：Follow up were ranged from 2 months to 44 months. Hypo-thyroidism occurred in 14 patients and other 24 patients remained euthyroid. Hypothyroid group had complete response （CR） 1 （7.14 %） ,partial response （PR） 5 （35.72%） ,stable disease （SD） 8 （57.14M） as the best tumor response. Euthyroid group had complete response （CR） 1 （4.17%） ,partial response （PR） 2 （8. 33%） , stable disease （SD） 18 （75. 00%） , and progression disease （PD） （12.500/oo ） as the best tumor response. Median progression-free survival was 9 months （95 % CI： 4.6=13.4） and median o-verall survival was 20 months （95 % CI：4.9-35.1） in euthyroid group. Median progression-free survival has not been reached in hypothyroid group, but was longer. Median overall survival has not been reached in hypothyroid group, and did not reach statistical significance. The most common adverse events were hand-foot syndrome, fatigue,leukopenia, thrombo-cytopenia,mucositis,and hypertension. There was no statistic significant difference between the two groups. CONCLU-SION：Sunitinib-induced hypothyroidism could prolong the median progression-free survival in advanced renal cell carcino-ma, and may prolong the median overall survival.

关 键 词：肾肿瘤 肿瘤转移 甲状腺功能减退症 血小板减少 

分 类 号：R737.11[医药卫生—肿瘤]