中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2013年
2期
143-146
,共4页
洪雅萍%朱耀%姚旭东%张世林%戴波%张海梁%沈益君%朱一平%马春光%肖文军%秦晓健%林国文%叶定伟
洪雅萍%硃耀%姚旭東%張世林%戴波%張海樑%瀋益君%硃一平%馬春光%肖文軍%秦曉健%林國文%葉定偉
홍아평%주요%요욱동%장세림%대파%장해량%침익군%주일평%마춘광%초문군%진효건%림국문%협정위
癌,肾细胞%分子靶向治疗%预后%MSKCC危险度分组
癌,腎細胞%分子靶嚮治療%預後%MSKCC危險度分組
암,신세포%분자파향치료%예후%MSKCC위험도분조
Carcinoma,renal cell%Molecular targeted therapy%Prognosis%Memorial Sloan-Kettering Cancer Center risk groups
目的 探讨分子靶向治疗晚期肾癌患者的疗效并对MSKCC危险度分组预后模型进行验证. 方法 晚期肾癌患者345例,年龄17～90岁,平均57岁.其中透明细胞癌306例,乳头状肾癌20例,嫌色细胞癌4例,肾集合管癌5例,髓样癌3例,未分类癌7例.常见转移部位为肺、骨和淋巴结.治疗方法:索拉非尼组205例,索拉非尼口服,400 mg,2次/d连续服药；舒尼替尼组140例,舒尼替尼口服,50 mg每天,用药4周,间歇2周为一个疗程.采用Kaplan-Meier法对生存资料进行分析,采用Log-rank检验和一致系数分析法对MSKCC危险度分组模型进行验证. 结果 总体中位随访时间23个月,中位总生存时间33个月,1、2、3年生存率分别为77.6％、59.3％、46.6％.根据MSKCC危险度分组,低、中、高危组分别169、150、26例,中位总生存时间分别为46、24、8个月(P＜0.01),2年生存率分别为75.8％、47.7％、10.1％.MSKCC危险度分组预测模型的一致系数为0.687. 结论 分子靶向治疗在我国晚期肾癌人群具有良好的临床疗效,MSKCC模型验证不仅有利于个体化的肿瘤预后判断,而且有利于与患者的交流和临床用药选择.
目的 探討分子靶嚮治療晚期腎癌患者的療效併對MSKCC危險度分組預後模型進行驗證. 方法 晚期腎癌患者345例,年齡17～90歲,平均57歲.其中透明細胞癌306例,乳頭狀腎癌20例,嫌色細胞癌4例,腎集閤管癌5例,髓樣癌3例,未分類癌7例.常見轉移部位為肺、骨和淋巴結.治療方法:索拉非尼組205例,索拉非尼口服,400 mg,2次/d連續服藥；舒尼替尼組140例,舒尼替尼口服,50 mg每天,用藥4週,間歇2週為一箇療程.採用Kaplan-Meier法對生存資料進行分析,採用Log-rank檢驗和一緻繫數分析法對MSKCC危險度分組模型進行驗證. 結果 總體中位隨訪時間23箇月,中位總生存時間33箇月,1、2、3年生存率分彆為77.6％、59.3％、46.6％.根據MSKCC危險度分組,低、中、高危組分彆169、150、26例,中位總生存時間分彆為46、24、8箇月(P＜0.01),2年生存率分彆為75.8％、47.7％、10.1％.MSKCC危險度分組預測模型的一緻繫數為0.687. 結論 分子靶嚮治療在我國晚期腎癌人群具有良好的臨床療效,MSKCC模型驗證不僅有利于箇體化的腫瘤預後判斷,而且有利于與患者的交流和臨床用藥選擇.
목적 탐토분자파향치료만기신암환자적료효병대MSKCC위험도분조예후모형진행험증. 방법 만기신암환자345례,년령17～90세,평균57세.기중투명세포암306례,유두상신암20례,혐색세포암4례,신집합관암5례,수양암3례,미분유암7례.상견전이부위위폐、골화림파결.치료방법:색랍비니조205례,색랍비니구복,400 mg,2차/d련속복약；서니체니조140례,서니체니구복,50 mg매천,용약4주,간헐2주위일개료정.채용Kaplan-Meier법대생존자료진행분석,채용Log-rank검험화일치계수분석법대MSKCC위험도분조모형진행험증. 결과 총체중위수방시간23개월,중위총생존시간33개월,1、2、3년생존솔분별위77.6％、59.3％、46.6％.근거MSKCC위험도분조,저、중、고위조분별169、150、26례,중위총생존시간분별위46、24、8개월(P＜0.01),2년생존솔분별위75.8％、47.7％、10.1％.MSKCC위험도분조예측모형적일치계수위0.687. 결론 분자파향치료재아국만기신암인군구유량호적림상료효,MSKCC모형험증불부유리우개체화적종류예후판단,이차유리우여환자적교류화림상용약선택.
Objective To validate the Memorial Sloan-Kettering Cancer Center(MSKCC)score model and evaluate the clinical efficacy of vascular endothelial growth factor(VEGF)-targeted agents in the treatment of advanced renal cell carcinoma(RCC)in China.Methods Three hundred and forty-five patients with advanced RCC and average age of 57(17-90)years were treated with VEGF-targeted agents.There were 306 cases of clear cell RCC,20 cases of papillary RCC,4 cases of chromophobe RCC,5 cases of renal collecting duct carcinoma,3 cases of medullary carcinoma and 7 cases of unclassified RCC.The main metastatic lesions were located at lung,bone and lymph nodes.Of them,205 cases were given the treatment of sorafenib 400 mg bid without off treatment,while 140 cases received sunitinib treatment in repeated six week cycles consisting of four weeks of sunitinib 50 mg daily followed by two weeks off treatment.Overall survival(OS)was estimated by the Kaplan-Meier method.Log-rank test and Harrell concordance index analysis were used to validate the MSKCC score model.Results The median follow-up period were 23(1-68)months in the whole group.The OS was 33 months,and survival rates at 1,2,3 year were 77.6％,59.3％,46.6％,respectively.According to the MSKCC score model,the patients were segregated into three risk categories: the favorable-risk group(no prognostic factors;n =169;49.0％),in which median OS(mOS)was 46 months and 2 year OS was 75.8％;the imtermediate-risk group(one or two prognostic factors;n =150;43.5％),in which mOS was 24 months and 2 year OS was 47.7％;and the poorrisk group(three to five prognostic factors;n =26;7.5％),in which mOS was 8 months and 2 year OS was 10.1％(log-rank P ＜ 0.01).The concordance index was 0.687.Conclusions VEGF-targeted agents are effective in Chinese advanced RCC patients.The MSKCC score model can be incorporated into judging individualizing tumor prognosis and communicating about the treatment options with patients who are using VEGF-targeted agents.
