摘要
目的总结舒尼替尼治疗晚期转移性肾癌中患者血液学不良反应的诊断、分级和处理经验。方法转移性肾癌患者62例。男44例，女18例。年龄25-75岁。临床诊断均为晚期或不可手术的肾细胞癌，并至少有1处可测量的转移病灶。初始患者均采用舒尼替尼50mg／d口服，用药4周，间歇2周的治疗方案。每个周期进行一次安全性评价，每2个周期进行一次疗效评价。结果62例患者中，出现血液学不良反应50例（80．6％），主要表现为血小板、白细胞降低和贫血，其中1-2度反应32例（51．6％），3-4度反应18例（29．0％）。1-2度反应给予药物对症治疗；3-4度反应需要将舒尼替尼减量或停药，同时予对症处理。58例患者经过治疗后最终耐受舒尼替尼治疗。21例药物减量，其中9例（42．9％）为血液学不良反应所致。结论舒尼替尼对晚期转移性肾癌的病情控制有显著效果，血液学不良反应是用药后较常见的现象，合理、及时地处理血液学不良反应是获得满意疗效的保证。
Objective To evaluate the hematological adverse events of sunitinib in treatment of ad- vanced renal cell carcinoma. Methods Forty-four male patients and 18 female patients were included in this study. They were all with metastatic renal cell carcinoma and received sunitinih treatment at the dose of 50 mg daily in repeated 6 weeks cycle （4 weeks on and 2 weeks off）. Toxicity was assessed every cycle with tumor assessments every 2 cycles via CT or PET-CT. Results Fifty patients （80.6%） had experienced treatment-related hematotoxicity, including leucoeytopenia, anemia and thromboeytopenia. Severe hematolog- ical adverse events （grade 3 -4） oecured in 18 patients （29.0%） and slight events （grade 1 -2） in others （51.6%）. Most of the hematological adverse events were manageable and reversible and treatment-changes （dose reduction, interruption） were necessary in severe cases. Almost half of the dose reduction （9/21 , 42.9 % ） were owing to hematotoxicity. Conclusions Sunitinib of 50 mg dose on schedule 4/2 is effective and well-tolerated in advanced renal carcinoma patients. Hematological adverse events are frequent in Chi- nese patients and can be controlled well.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2012年第8期627-630,共4页
Chinese Journal of Urology
关键词
癌
肾细胞
苹果酸舒尼替尼
药物毒性
血液学
Carcinoma, renal cell
Malate sunitinib
Drug toxicity
Hematology
