索拉非尼治疗转移性非透明细胞肾癌的疗效观察

目的 初步探讨索拉非尼治疗转移性非透明细胞肾癌的疗效.方法 转移性非透明细胞肾癌21例,中位年龄45(25～76)岁.12例为根治性肾切除术后出现转移,9例就诊时诊断为肾癌伴转移,行减瘤性肾切除术.术后病理证实乳头状癌15例、嫌色细胞癌1例、未分类癌5例.转移部位包括肺、淋巴结、肾上腺、骨、肝和甲状腺.治疗方法:①索拉非尼400 mg,2次/d治疗15例;②索拉非尼400 mg,2次/d加干扰素α 300万U,每周连续5 d皮下注射治疗6例.中位治疗时间8(2～21)个月.随访0～22个月.结果 部分缓解(PR)3例(14.3%),其肿瘤病理亚型分别为乳头状癌、嫌色细胞癌和未分类癌各1例,转移灶分别位于腹膜后加纵隔淋巴结、肺加腹膜后淋巴结和腹膜后加盆腔淋巴结.疾病稳定(SD)13例(61.9%),疾病进展(PD)5例(23.8%),疾病控制率76.2%.截至2009年7月,出现PD 13例,中位无疾病进展时间为7(0～21)个月.结论 索拉非尼治疗转移性肾乳头状癌、嫌色细胞癌、未分化癌有效,对淋巴结转移及肺转移者的疗效相对较好.

Efficacy of sorafenib in treating metastatic non-clear cell renal cell carcinoma

Objective To investigate the efficacy of sorafenib in treating metastatic non-clear cell renal cell carcinoma(RCC).Methods Twenty-one patients with metastatic non-clear cell subtype renal cell carcinoma were treated with sorafenib.Thirteen cases were male,8 were female,with a median age of 45 years(25-76 years).Metastasis occurred in 12 cases after radical nephrectomy,and the other 9 cases received cytoreductive surgery.Pathological diagnosis showed 15 papillary RCCs,1 chromophobe RCC,and 5 unclassified RCCs.The metastatic lesions were located at lung,lymph node,adrenal gland,bone,liver,and thyroid gland.The patients were given the treatment of sorafenib 400 mg bid,or sorafenib 400 mg bid in combination with interferon-α 3 MIU,IH.5 days per week,and the median time of treatment was 8 months (2-21 months).Results Three cases (14.3%)with 1 papillary RCC,1 chromophobe RCC,and 1 unclassified RCC reached partial remission(PR) and 13 cases (61.9%) maintained stable disease (SD) for more than 12 weeks.And the rest 5 cases(23.8%) progressed(PD).To Jul 2009,13 cases progressed and the median progression free survival was 7 months(0-21 months).Conclusions Sorafenib has definitive efficacy in metastatic papillary RCC,chromophobe RCC,and unclassified RCC.Metastatic lesions in lungs and Lymph nodes might be more sensitive to sorafenib.