舒尼替尼治疗46例转移性肾癌的预后因素分析  

Analysis on the prognostic factors of 46 patients with metastatic renal carcinoma treated by sunitinib

作　　者：陈雪 刘开泰[1] 贝宴屏 郑璐[1] 

机构地区：[1]宁波市医疗中心李惠利医院,浙江宁波315000

出　　处：《中国现代医生》2017年第25期11-14,共4页China Modern Doctor

基　　金：浙江省宁波市自然科学基金资助项目(2017A610193)

摘　　要：目的分析舒尼替尼治疗转移性肾癌(mRCC)的预后因素。方法回顾性分析2008年1月~2013年12月在我院使用舒尼替尼治疗的46例mRCC患者的临床资料。采用Kaplan-Meier生存分析法计算患者的生存率,Log-rank检验生存率差异,应用Cox比例回归风险模型分析影响预后的相关因素。结果本组46例的中位总生存时间为27.8个月(95%CI:15.7~39.9个月),客观缓解率为21.7%,疾病控制率为69.5%。Kaplan-Meier生存分析结果显示1年、2年、3年总生存率分别为77.8%、57.2%、38.7%。单因素分析:确诊至开始治疗时间<1年(P<0.01)、ECOG评分>2分(P<0.01)、未行肾根治性切除术/减瘤术(P<0.01)、非肺转移(P=0.045)、骨转移(P<0.01)、肝转移(P<0.01)、多器官转移(P=0.012)、MSKCC模型评分为高危(P<0.01)、舒尼替尼1M-RDI<50%(P<0.01)影响转移性肾癌的总生存期。Cox多因素分析显示诊断至接受治疗时间间隔(<1年与≥1年)、肿瘤转移器官数目(1个与≥1个)是舒尼替尼治疗转移性肾癌总生存期的独立预后因素(P<0.05),是影响转移性肾癌预后的独立因素。结论治疗时间间隔≥1年以及单一器官转移的转移性肾癌患者接受舒尼替尼治疗能够获得较好的总生存时间,是影响转移性肾癌预后的独立因素。Objective To analyze the prognostic factors of sunitinib in the treatment of metastatic renal carcinoma.Methods The clinical data of 46 patients with m RCC treated with sunitinib in our hospital from January 2008 to December 2013 were retrospectively analyzed. Kaplan-Meier survival analysis was used to calculate the survival rate of the patients, and Log-rank test was used to test the differences of survival rate. The Cox proportional regression risk model was used to analyze the relevant influencing factors for prognosis. Results The median overall survival time was27.8 months(95%CI: 15.7 to 39.9 months) in 46 patients in this group, and the objective remission rate was 21.7%.The disease control rate was 69.5%. Kaplan-Meier survival analysis showed that 1-year, 2-year, 3-year overall survival rates were 77.8%, 57.2% and 38.7%, respectively. Univariate analysis: treatment time less than one year from diagnosis to beginning of treatment(P<0.01), ECOG score>2 points(P<0.01), no radical nephrectomy/tumor cytoreduction(P<0.01), non-pulmonary metastasis(P=0.045), bone metastasis(P<0.01), liver metastasis(P<0.01), multiple organ metastasis(P=0.012), MSKCC model score in high risk(P<0.01), relative dose density of sunitinib in the first month <50%(P<0.01) all affected the overall survival of metastatic renal carcinoma. Cox multivariate analysis showed the interval from diagnosis to treatment(<1 year and ≥1 year) and the number of metastatic organs(1 and ≥1) were independent prognostic factors of sunitinib in the treatment of overall survival of metastatic renal carcinoma(P<0.05), which was an independent factor affecting the prognosis of metastatic renal carcinoma. Conclusion Sunitinib for the patients with metastatic renal carcinoma at a time interval of ≥1 year and single organ metastasis can achieve a good overall survival time and is an independent factor affecting the prognosis of metastatic renal carcinoma.

关 键 词：舒尼替尼 转移性肾癌 总生存期 多因素分析 预后 

分 类 号：R73[医药卫生—肿瘤]