中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2012年
12期
895-897
,共3页
索拉非尼%血液透析%癌,肾细胞
索拉非尼%血液透析%癌,腎細胞
색랍비니%혈액투석%암,신세포
Sorafenib%Hemodialysis%cell Carcinoma,renal
目的 探讨索拉非尼治疗伴有终末期肾病的转移性肾癌的可行性. 方法 应用索拉非尼治疗伴有终末期肾病的转移性肾癌患者1例.患者,女,65岁.左肾透明细胞癌接受根治性肾切除术后4个月,因终末期肾病开始血液透析.术后12个月,发现双肺转移.应用干扰素或IL-2治疗无效.二线应用索拉非尼400 mg,2次/d口服.维持血液透析每周3次.通过PubMed检索相关文献报道结果,总结其可行性. 结果 索拉非尼治疗前右肺病灶大小2.7 cm ×2.4 cm,左肺病灶2.6 cm×2.0 cm.服药2个月时因手足皮肤反应停药2周,恢复治疗后持续用药至2011年12月共52个月.用药6个月时,双肺转移病灶均有缩小,疗效评价为稳定(SD,REGIST标准).服药12个月时,双肺病灶继续缩小,右肺病灶1.8cm×1.0,cm;左肺病灶呈条索样,疗效评价为部分缓解(PR).至随访截止,双肺病灶均已呈条索样改变.检索PubMed共有6篇类似报道,患者9例,其中疗效评价7例,PR 3例,SD 4例.药物不良反应无明显加重. 结论 索拉非尼治疗伴有终末期肾病的转移性肾癌疗效确实,不良反应与肾功能正常患者相似.
目的 探討索拉非尼治療伴有終末期腎病的轉移性腎癌的可行性. 方法 應用索拉非尼治療伴有終末期腎病的轉移性腎癌患者1例.患者,女,65歲.左腎透明細胞癌接受根治性腎切除術後4箇月,因終末期腎病開始血液透析.術後12箇月,髮現雙肺轉移.應用榦擾素或IL-2治療無效.二線應用索拉非尼400 mg,2次/d口服.維持血液透析每週3次.通過PubMed檢索相關文獻報道結果,總結其可行性. 結果 索拉非尼治療前右肺病竈大小2.7 cm ×2.4 cm,左肺病竈2.6 cm×2.0 cm.服藥2箇月時因手足皮膚反應停藥2週,恢複治療後持續用藥至2011年12月共52箇月.用藥6箇月時,雙肺轉移病竈均有縮小,療效評價為穩定(SD,REGIST標準).服藥12箇月時,雙肺病竈繼續縮小,右肺病竈1.8cm×1.0,cm;左肺病竈呈條索樣,療效評價為部分緩解(PR).至隨訪截止,雙肺病竈均已呈條索樣改變.檢索PubMed共有6篇類似報道,患者9例,其中療效評價7例,PR 3例,SD 4例.藥物不良反應無明顯加重. 結論 索拉非尼治療伴有終末期腎病的轉移性腎癌療效確實,不良反應與腎功能正常患者相似.
목적 탐토색랍비니치료반유종말기신병적전이성신암적가행성. 방법 응용색랍비니치료반유종말기신병적전이성신암환자1례.환자,녀,65세.좌신투명세포암접수근치성신절제술후4개월,인종말기신병개시혈액투석.술후12개월,발현쌍폐전이.응용간우소혹IL-2치료무효.이선응용색랍비니400 mg,2차/d구복.유지혈액투석매주3차.통과PubMed검색상관문헌보도결과,총결기가행성. 결과 색랍비니치료전우폐병조대소2.7 cm ×2.4 cm,좌폐병조2.6 cm×2.0 cm.복약2개월시인수족피부반응정약2주,회복치료후지속용약지2011년12월공52개월.용약6개월시,쌍폐전이병조균유축소,료효평개위은정(SD,REGIST표준).복약12개월시,쌍폐병조계속축소,우폐병조1.8cm×1.0,cm;좌폐병조정조색양,료효평개위부분완해(PR).지수방절지,쌍폐병조균이정조색양개변.검색PubMed공유6편유사보도,환자9례,기중료효평개7례,PR 3례,SD 4례.약물불량반응무명현가중. 결론 색랍비니치료반유종말기신병적전이성신암료효학실,불량반응여신공능정상환자상사.
Objective To investigate the safety and feasibility of sorafenib in metastatic renal cell carcinoma (mRCC) patients with end-stage renal disease (ESRD) undergoing hemodialysis.Methods A case of 65-year-old female patient on hemodialysis and receiving sorafenib treatment for mRCC was reported.Literatures were searched through PubMed for such mRCC with ESRD.Results The patient underwent a left radical nephrectomy because of clear cell RCC.Hemodialysis was introduced because of ESRD four months after the nephrectomy.Lung metastases were found one year after the operation.With the failure of immunotherapy,the patient received sorafenib 800 mg daily.Hemodialysis was carried out three times weekly.The initial sizes of right and left lung metastases were 2.7 cm × 2.4 cm and 2.6 cm× 2.0 cm respectively.The patient achieved stable disease six months later (to 2.4 cm × 1.4 cm and 2.0 cm × 1.8 cm respectively) and partial remission one year later (to 1.8 cm × 1.0 cm and fibrosis respectively).Currently the patient has been under sorafenib treatment for 52 months.The pulmonary lesions were nearly replaced by fibrosis and calcification.Totally six case reports were found through PubMed including nine patients with ESRD and mRCC.The best objective response was partial response in three cases,stable disease in four cases and unknown in the other two cases.Sorafenib was generally well tolerated.Conclusion Treatment of patients with metastatic renal cell carcinoma undergoing hemodialysis with sorafenib appears to be feasible.
