中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2012年
42期
2998-3000
,共3页
杨邵瑜%崔传亮%迟志宏%斯璐%盛锡楠%毛丽丽%连斌%郭军
楊邵瑜%崔傳亮%遲誌宏%斯璐%盛錫楠%毛麗麗%連斌%郭軍
양소유%최전량%지지굉%사로%성석남%모려려%련빈%곽군
癌,肾细胞%药物疗法%胸腔积液%索拉非尼
癌,腎細胞%藥物療法%胸腔積液%索拉非尼
암,신세포%약물요법%흉강적액%색랍비니
Carcinoma,renal cell%Drug therapy%Pleural effusion%Sorafenib
目的 评价索拉非尼联合胸腔化疗治疗晚期肾癌伴胸腔积液患者的疗效、生存期及相关不良反应.方法 选择2009年6月至2011年1月晚期肾癌合并胸腔积液患者30例,病理均为透明细胞癌,全身治疗均使用索拉菲尼400 mg每日2次口服.胸腔化疗组患者11例,口服索拉非尼同时以顺铂(Cisplatin,DDP)40 mg每周1次胸腔灌注化疗,连续2周,单纯引流组19例,予以单纯胸腔引流及口服索拉非尼治疗.随访至2011年4月30日.结果 胸腔化疗组胸腔积液控制率高于单纯引流组(10/11比3/19,x2=13.097,P ＜0.01).自出现胸腔积液起随访至2011年4月30日,胸腔化疗组11例患者中5例死亡,单纯引流组19例患者中10例死亡.胸腔化疗组中位总生存时间22个月(95％CI:2.12 ～41.88个月),单纯引流组9个月(95％ CI:8.20 ～ 9.80个月),P=0.04.常见不良反应:Ⅰ～Ⅱ度的胸痛:胸腔化疗组高于单纯引流组(8/11比4/19,P＜0.01),Ⅰ～Ⅱ度的恶心、呕吐:胸腔化疗组高于单纯引流组(9/11比3/19,P＜0.01).两组实验室检测异常差异无统计学意义.结论 索拉非尼联合胸腔灌注化疗控制肾癌伴发的胸腔积液安全有效；可控制局部症状,对出现胸腔积液后患者的总生存有延长趋势.
目的 評價索拉非尼聯閤胸腔化療治療晚期腎癌伴胸腔積液患者的療效、生存期及相關不良反應.方法 選擇2009年6月至2011年1月晚期腎癌閤併胸腔積液患者30例,病理均為透明細胞癌,全身治療均使用索拉菲尼400 mg每日2次口服.胸腔化療組患者11例,口服索拉非尼同時以順鉑(Cisplatin,DDP)40 mg每週1次胸腔灌註化療,連續2週,單純引流組19例,予以單純胸腔引流及口服索拉非尼治療.隨訪至2011年4月30日.結果 胸腔化療組胸腔積液控製率高于單純引流組(10/11比3/19,x2=13.097,P ＜0.01).自齣現胸腔積液起隨訪至2011年4月30日,胸腔化療組11例患者中5例死亡,單純引流組19例患者中10例死亡.胸腔化療組中位總生存時間22箇月(95％CI:2.12 ～41.88箇月),單純引流組9箇月(95％ CI:8.20 ～ 9.80箇月),P=0.04.常見不良反應:Ⅰ～Ⅱ度的胸痛:胸腔化療組高于單純引流組(8/11比4/19,P＜0.01),Ⅰ～Ⅱ度的噁心、嘔吐:胸腔化療組高于單純引流組(9/11比3/19,P＜0.01).兩組實驗室檢測異常差異無統計學意義.結論 索拉非尼聯閤胸腔灌註化療控製腎癌伴髮的胸腔積液安全有效；可控製跼部癥狀,對齣現胸腔積液後患者的總生存有延長趨勢.
목적 평개색랍비니연합흉강화료치료만기신암반흉강적액환자적료효、생존기급상관불량반응.방법 선택2009년6월지2011년1월만기신암합병흉강적액환자30례,병리균위투명세포암,전신치료균사용색랍비니400 mg매일2차구복.흉강화료조환자11례,구복색랍비니동시이순박(Cisplatin,DDP)40 mg매주1차흉강관주화료,련속2주,단순인류조19례,여이단순흉강인류급구복색랍비니치료.수방지2011년4월30일.결과 흉강화료조흉강적액공제솔고우단순인류조(10/11비3/19,x2=13.097,P ＜0.01).자출현흉강적액기수방지2011년4월30일,흉강화료조11례환자중5례사망,단순인류조19례환자중10례사망.흉강화료조중위총생존시간22개월(95％CI:2.12 ～41.88개월),단순인류조9개월(95％ CI:8.20 ～ 9.80개월),P=0.04.상견불량반응:Ⅰ～Ⅱ도적흉통:흉강화료조고우단순인류조(8/11비4/19,P＜0.01),Ⅰ～Ⅱ도적악심、구토:흉강화료조고우단순인류조(9/11비3/19,P＜0.01).량조실험실검측이상차이무통계학의의.결론 색랍비니연합흉강관주화료공제신암반발적흉강적액안전유효；가공제국부증상,대출현흉강적액후환자적총생존유연장추세.
Objective To evaluate the safety and efficacy of sorafenib plus cisplatin in the treatment of metastatic renal cell carcinoma (mRCC) with pleural effusion.Methods A total of 30 patients with mRCC (clear cell carcinoma) with pleural effusion from April 2009 to January 2011 were recruited.All received sorafenib 400 mg twice daily.And 11 patients in chemotherapy group received sorafenib plus local chemotherapeutic perfusion of cisplatin 40 mg weekly for 2 weeks while another 19 patients in control group received sorafenib alone.Results The response rate of pleural effusion was 10/11 for chemotherapy group versus 3/19 for control group (x2 =13.097,P ＜ 0.01).Followed up to April 30th,2011,5 of 11 patients in chemotherapy group and 10 of 19 patients in control group died.Among those on sorafenib,the median overall survival time was 22 months(95％ CI:2.12-41.88)for local chemotherapy versus 9 months(95％ CI:8.20-9.80) without local therapy(P =0.04).The most common events in local chemotherapy group were Ⅰ-Ⅱ thoracic pain,nausea and vomiting.And the incidence rates were 8/11 and 9/11 versus 4/19 and 3/19 respectively (P ＜ 0.01).The main laboratory abnormalities were similar in two groups.Conclusion The regimen of sorafenib plus pleural cavity perfusion of cisplatin is both effective and safe in the treatment of mRCC with pleural effusion.It may control local symptoms and achieve a better overall survival.
