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目的:探讨舒尼替尼对晚期肾癌患者不同转移灶的有效性。方法:晚期肾癌患者12例,男8例,女4例,平均年龄53岁。其中7例为根治性肾切除术后发现复发或转移,4例为发现肾癌时已不能完全切除所有病灶仅作患肾切除,1例肾穿刺证实为肾癌但未能行手术。病理诊断均为透明细胞癌。均以舒尼替尼作为一线药物,采用单一用药,口服50mg/d,每4周停2周乾7例,口服37.5 mg/d连续用药者5例,持续用药至肿瘤进展或出现不可耐受的不良反应。结果:平均服用舒尼替尼35周。部分缓解3例,疾病稳定6例,疾病进展3例,无完全缓解病例。客观反应率25.0%,疾病控制率75.0%。缓解病例多为局部复发及肺转移病灶,进展病例均为骨转移病灶。常见的不良包括手足皮肤反应、皮疹、食欲减退、疲劳乏力、骨髓抑制、味觉变化等。多为1～2级不良反应。结论:舒尼替尼治疗晚期肾癌患者有效,不良反应较轻,但其对不同器官组织转移灶的有效性可能存在一定的差异。
Objective: To investigate the efficacy of sunitinib in patients with advanced renal cell carcinoma of different metastases. Methods: 12 patients with advanced renal cell carcinoma, 8 males and 4 females, mean age 53 years. Seven of them were found to have recurrence or metastasis after radical nephrectomy. Four cases were found to have failed to completely remove all the lesions for nephrectomy and only one nephrectomy was performed. One case of renal puncture confirmed renal cell carcinoma but failed to perform surgery. Pathological diagnosis is clear cell carcinoma. Sunitinib as a first-line drugs, a single medication, oral 50mg / d, stopping every 4 weeks 2 weeks dry 7 cases, oral administration of 37.5 mg / d continuous medication in 5 cases, continued treatment until tumor progression or intolerable Adverse reactions. RESULTS: Sunitinib was given on average for 35 weeks. Partial relief in 3 cases, stable disease in 6 cases, 3 cases of disease progression, no complete remission cases. The objective response rate was 25.0% and the disease control rate was 75.0%. Mitigating cases were mostly local recurrence and lung metastases, the progress of cases were bone metastases. Common adverse reactions include hand-foot skin reactions, rashes, loss of appetite, fatigue, bone marrow suppression, changes in taste and so on. Mostly 1 to 2 adverse reactions. CONCLUSIONS: Sunitinib is effective in treating patients with advanced renal cell carcinoma and has mild adverse reactions. However, there may be some differences in the efficacy of sunitinib in different organs and metastases.