减瘤性肾切除术联合舒尼替尼治疗肾癌合并肺转移患者的疗效与安全性  

EFFICACY AND SAFETY OF CYTOREDUCTIVE NEPHRECTOMY COMBINED WITH SUNITINIB IN TREATMENT OF PATIENTS WITH RENAL CANCER AND LUNG METASTASES

作　　者：王鹏[1] 江涛[1] 张文凤 吴文峰 WANG Peng;JIANG Tao;ZHANG Wenfeng;WU Wenfeng(Department of Urology,Tangshan People's Hospital,Tangshan 063000,China)

机构地区：[1]河北省唐山市人民医院泌尿外一科,063000

出　　处：《中国煤炭工业医学杂志》2023年第2期128-133,共6页Chinese Journal of Coal Industry Medicine

基　　金：2023年度河北省医学科学研究重点科技研究计划(编号:20231806)。

摘　　要：目的 评价减瘤性肾切除术联合舒尼替尼治疗肾癌合并肺转移患者的疗效与安全性。方法 回顾性分析该院2015年3月—2021年1月收治的26例肾癌合并肺转移患者的临床资料。其中17例患者为先行减瘤性肾切除术,术后给予舒尼替尼靶向治疗,称为联合手术组。9例患者单用舒尼替尼靶向治疗,称为对照组。评价两组患者的客观缓解率(ORR)、疾病控制率(DCR)、无进展生存时间(PFS)、总生存时间(OS)、24个月生存率和不良反应发生情况。结果 26例患者总中位随访时间是22.5(8~63)个月,其中有2例患者仍在继续治疗。与对照组患者比较,联合手术组患者的客观缓解率(ORR)更高(23.53%vs.11.11%),疾病控制率(DCR)更高(94.12%vs.88.89%),无进展生存时间(PFS)更长(15 vs.9个月),总生存时间(OS)更长(26 vs.16个月),24个月生存率更高(58.82%vs.11.11%),不良反应发生差异不大,经药物减量和对症治疗可耐受。结论 减瘤性肾切除术联合舒尼替尼治疗肾癌合并肺转移优于单用舒尼替尼,可延长无疾病进展时间和总生存时间,且不良反应可控,可使患者生存获益。Objective To assess the efficacy and safety of cytoreductive nephrectomy combined with sunitinib in the treatment of patients with renal cancer and lung metastases. Methods We retrospectively analyzed the clinical data of twenty-six patients with renal cancer and lung metastases admitted to our hospital from March 2015 to January 2021.Among them, seventeen patients were given cytoreductive nephrectomy and combined with sunitinib targeted therapy, which was called the combined surgery group.Nine patients were treated with sunitinib alone, called the control group.We assessed objective response rates(ORR),disease control rates(DCR),progression-free survival(PFS),overall survival(OS),the survival rate of twenty-four months, and the incidence of adverse reactions in both groups. Results The overall median follow-up for twenty-six patients was 22.5(8 to 63) months, and two of them continued treatment.Compared with the control group, the objective response rate(ORR) was higher(23.53% vs.11.11%),the disease control rate(DCR) was higher(94.12% vs.88.89%),the progression-free survival(PFS) was longer(15 vs.9 months),the overall survival(OS) was longer(26 vs.16 months),and the survival rate of twenty-four months was higher(58.82% vs.11.11%).There was little difference in adverse reactions between the two groups.Patients are tolerated by drug reduction and symptomatic therapy. Conclusion Cytoreductive nephrectomy combined with sunitinib is better than sunitinib alone in the treatment of renal cancer with lung metastasis.It can prolong progression-free survival and overall survival.And adverse effects are controllable.It provides survival benefits.

关 键 词：肾癌 肺转移癌 舒尼替尼 减瘤手术 肾切除术 不良反应 

分 类 号：R699.3[医药卫生—泌尿科学]