肾细胞癌肝、骨转移对舒尼替尼靶向治疗患者的预后影响  

Analysis of association between renal cell carcinoma liver and bone metastases and the clinical outcome of patients treated with sunitinib

作　　者：顾伟杰[1,2] 施国海[1,2] 常坤[1,2] 韩成涛 戴波[1,2] 张海梁[1,2] 朱耀[1,2] 沈益君[1,2] 朱一平[1,2] 叶定伟[1,2] 

机构地区：[1]复旦大学附属肿瘤医院泌尿外科,上海200032 [2]复旦大学上海医学院肿瘤学系

出　　处：《临床泌尿外科杂志》2015年第6期485-488,共4页Journal of Clinical Urology

摘　　要：目的：探究肾癌转移部位在接受舒尼替尼靶向治疗晚期肾细胞癌患者预后的相关性。方法：回顾性分析2008年3月～2014年2月在我院接受靶向治疗的肾癌患者157例临床资料,Kaplan-Meier生存曲线分析各转移部位与患者总生存的关系。单因素和多因素Cox回归模型进一步分析各个转移部位与患者预后的相关性。结果：本组研究患者中位生存时间为25个月。Kaplan-Meier生存曲线分析结果显示存在肝转移（11.1个月vs21.1个月,P=0.020）和骨转移（12.3个月vs 21.3个月,P=0.002）的肾癌患者总生存时间显著减少。单因素Cox回归分析结果显示肾癌患者中存在肝（HR：2.329;95%CI：1.114～4.867,P=0.025）和骨（HR：1.889;95%CI：1.200～2.974,P=0.006）转移的预后不良。采用MSKCC危险度分层和转移部位数目进行校正后,多因素Cox回归分析结果显示存在肝和骨转移仍有显著意义。结论：舒尼替尼治疗的晚期肾癌患者存在肝脏和骨骼转移预示着不良的预后,可作为MSKCC危险度评估预后的补充。Objective：To evaluate the effects of different metastatic lesions on prognosis of patients with advanced renal cell carcinoma（RCC）treated with sunitinib.Method：Clinical data of 157 patients of RCC treated with sunitinib in Fudan University Shanghai Cancer Center from 2008 to 2014were retrospectively analyzed.Overall survival was estimated by the Kaplan-Meier method.Univariate and multivariate Cox analysis were performed to calculate the crude and adjusted hazard ratio of different metastatic lesions for overall survival.Result：The median survival time was 25 months.Kaplan-Meier analysis showed liver（11.1months vs 21.1months,P =0.020）and bone（12.3 months vs 21.3 months,P =0.002）metastases were associated with shorter overall survival.Univariate Cox analysis showed liver（HR：2.329;95%CI：1.114-4.867,P =0.025）and bone（HR：1.889;95%CI：1.200-2.974,P =0.006）metastases were significant independent predictors of poor prognosis.Adjusted for Memorial Sloan Kettering Cancer Center（MSKCC）score and number of metastatic sites,multivariate Cox analysis revealed the similar results.Conclusion：The RCC patients treated with sunitinib with liver and bone metastatic lesions are considered to be useful predictors of poor overall survival and supplementaries to MSKCC score.

关 键 词：肾细胞癌 舒尼替尼 转移部位 生存时间 

分 类 号：R737.11[医药卫生—肿瘤]