摘要
目的探讨索拉菲尼与舒尼替尼对转移性肾细胞癌患者的近远期疗效及其预后影响因素。方法选取2015年1月至2018年1月间榆林市第一医院收治的79例转移性肾细胞癌患者,根据治疗方法不同分为舒尼替尼组(39例)和索拉非尼组(40例)。索拉非尼组患者口服索拉非尼,舒尼替尼组患者口服舒尼替尼,比较两组患者的中位无进展生存时间、总生存时间、疾病控制率及不良反应发生情况,分析转移性肾细胞癌患者无进展生存时间及总生存时间的影响因素。结果索拉非尼组患者中位无进展生存时间为12个月,总生存时间为24个月;舒尼替尼组患者中位无进展生存时间为12个月,总生存时间为23个月。两组比较,差异均无统计学意义(P>0.05)。索拉非尼组患者疾病控制率为62.5%(25/40),低于舒尼替尼组患者的84.6%(33/39),差异有统计学意义(P<0.05)。索拉非尼组患者腹泻发生率高于舒尼替尼组,血小板下降低于舒尼替尼组,差异均有统计学意义(均P<0.05)。两组患者手足综合征、乏力、高血压、皮疹、中性粒细胞下降、肝功能异常、贫血和脱发发生情况比较,差异无统计学意义(P>0.05)。单因素及Cox回归分析结果表明,Fuhrman和IMDC分级是转移性肾细胞癌患者无进展生存时间和总生存时间的独立影响因素,差异均有统计学意义(均P<0.05)。结论与索拉非尼相比,舒尼替尼对转移性肾癌的疾病控制率更好,两种药物不良反应分布不同,但均可控制。Fuhrman和IMDC分级是影响转移性肾癌预后的独立影响因素。
Objective To investigate the short-and long-term efficacy of sorafenib and sunitinib for metastatic renal cell carcinoma and the factors influencing the prognosis.Methods Seventy-nine patients with metastatic renal cell carcinoma admitted to The First Hospital of Yulin from January 2015 to January2018 were selected.They were enrolled into a sunitinib group(39 patients)and a sorafenib group(40 patients)according to different therapies they received.The patients in the sorafenib group were given oral sorafenib,and patients in the sunitinib group were given oral sunitinib.The median progression-free survival,overall survival,disease control rate and incidence of adverse reactions were compared between the two groups.Factors influencing the progression-free survival and overall survival were analyzed.Results The median progression-free survival and overall survival was 12 months and 24 months,respectively for the sorafenib group and 12 months and 23 months,respectively for the sunitinib group(P>0.05).The disease control rate was 62.5%(25/40)for the sorafenib group which was lower than 84.6%(33/39)of sunitinib group(P<0.05).The incidence of diarrhea was higher in the sorafenib group than in the sunitinib group,and the incidence of thrombocytopenia was lower in the sorafenib group than in the sunitinib group(P<0.05).There was no statistical significance in the incidence of hand and foot syndrome,fatigue,hypertension,rash,neutropenia,liver dysfunction,anemia and alopecia between the two groups(all P>0.05).The univariate and Cox regression analysis showed that Fuhrman grading and IMDC grading were independent factors influencing progression-free survival and overall survival in patients with metastatic renal cell carcinoma.Conclusion Compared with sorafenib,sunitinib has a good disease control rate for metastatic renal cancer.Although the distribution of adverse reactions in the two groups is different the adverse reactions can be controlled.Fuhrman grading and IMDC grading are independent factors influeincing the prognosis of metastatic renal cancer.
作者
王晓琴
高慧
刘静静
王彤
张伟
康艳生
罗秋菊
WANG Xiao-qin;GAO Hui;UU Jing-jing;WANG Tong;ZHANG Wei;KANG Yan-sheng;LUO Qiu-ju(Department of Pharmacy,The First Hospital of Yulin,Yulin 719000,China;Department of Pharmacy,The Second Hospital of Yulin,Yulin 719000,China;Department of Renal Medicine,The First Hospital of Yulin,Yulin 719000,China)
出处
《中国肿瘤临床与康复》
2019年第12期1467-1470,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
