CAJ | 학술논문

目的探讨舒尼替尼治疗晚期肾癌的血细胞毒性.方法对2008-2011年在复旦大学附属肿瘤医院行舒尼替尼治疗的136例晚期肾癌患者进行回顾性分析,其中男91例,女45例,平均年龄为55.5岁.治疗方法:舒尼替尼口服,每天50 mg,用药4周,间歇2周为1个疗程.参见美国国立癌症研究所常见毒性反应标准3.0版本(NCI-CTCAE v3.0)对患者出现的血液学毒性进行分级,采用配对Wilcoxon检验分析舒尼替尼治疗过程中血液学毒性动力学变化规律.结果舒尼替尼治疗的136例晚期肾癌患者中91例(66.9％)出现白细胞减少；89例(65.4％)出现血小板减少,其中31例(22.8％)血小板减少3或4级；95例(69.8％)出现中性粒细胞减少；58例(42.6％)出现淋巴细胞减少；48例(35.3％)出现低血红蛋白血症.包括白细胞、中性粒细胞、血小板在内的血细胞在治疗后的第14、28和42天的计数水平均较治疗前的水平降低(均P＜0.01).血红蛋白检测值在治疗过程中短暂性升高(均P ＜0.05),在第42天回降至治疗前水平(P＞0.05).结论舒尼替尼治疗肾癌患者的血液学不良反应同国外报道的不尽相同,其中血小板减少症3或4级较西方国家研究报道的发生率高,应予重视.
목적 탐토서니체니치료만기신암적혈세포독성.방법 대2008-2011년재복단대학부속종류의원행서니체니치료적136례만기신암환자진행회고성분석,기중남91례,녀45례,평균년령위55.5세.치료방법:서니체니구복,매천50 mg,용약4주,간헐2주위1개료정.삼견미국국립암증연구소상견독성반응표준3.0판본(NCI-CTCAE v3.0)대환자출현적혈액학독성진행분급,채용배대Wilcoxon검험분석서니체니치료과정중혈액학독성동역학변화규률.결과 서니체니치료적136례만기신암환자중91례(66.9％)출현백세포감소；89례(65.4％)출현혈소판감소,기중31례(22.8％)혈소판감소3혹4급；95례(69.8％)출현중성립세포감소；58례(42.6％)출현림파세포감소；48례(35.3％)출현저혈홍단백혈증.포괄백세포、중성립세포、혈소판재내적혈세포재치료후적제14、28화42천적계수수평균교치료전적수평강저(균P＜0.01).혈홍단백검측치재치료과정중단잠성승고(균P ＜0.05),재제42천회강지치료전수평(P＞0.05).결론 서니체니치료신암환자적혈액학불량반응동국외보도적불진상동,기중혈소판감소증3혹4급교서방국가연구보도적발생솔고,응여중시.
Objective To explore the hematologic adverse effects in patients with renal cell carcinoma treated with sunitinib.Methods A total of 136 patients with advanced renal cell carcinoma were treated with sunitinib at our hospital from 2008 to 2011.There were 91 males and 45 females with an average age of 55.5 years.They received sunitinib in repeated 6-week cycles consisting of 4 weeks of sunitinib 50 mg per day followed by 2 weeks of treatment (schedule 4/2).The hematologic toxicities,collected at baseline and 14,28,42 (after a 2-week rest period) days,were graded according to the National Cancer Institute common terminology criteria for adverse events version 3.0.The paired Wilcoxon test was used to evaluate the kinetics of hematologic adverse effects at days 14,28,and 42 post-treatment.Results The hematologic toxicities included leukopenia (n =91,66.9％),neutropenia (n =95,69.8％),lymphopenia (n =58,46.2％),thrombopenia (n =89,65.4％) and hypohemoglobinemia (n =48,35.3％).Among them,31cases(22.8％)had the high-grade (including grades 3 and 4)toxicity of thrombopenia.There were depressions in hematopoietic cell populations including leukocytes,neutrophils,and platelets at days 14,28 and 42 versus the baseline level (all P ＜ 0.05).The median hemoglobin level transiently increased at days 14 and 28 (both P ＜ 0.01) and returned to the level of baseline at days 42 (P =0.754).Conclusions The incidence of hematologic adverse effects of sunitinib slightly varies with what have been observed in previous studies.And the incidence of high-grade toxicity of thrombocytopenia is higher than that reported in studies conducted in the US and Europe.