摘要
目的 探讨肾癌骨转移的临床特点及治疗效果。 方法 对 2 6例肾癌骨转移患者先期行辅助性肾切除后 ,根据骨转移情况不同分三组进行治疗。第 1组 :骨孤立转移灶 12例 ,行彻底切除 ;第 2组 :多发骨转移有潜在性病理骨折或截瘫危险患者 8例 ,选择性行骨病灶肿瘤囊内刮除或椎板减压 +固定术 ;第 3组 :多发骨转移患者 6例 ,骨转移病灶未行手术治疗。 3组均接受系统性免疫治疗。随访时间 4～ 6 6个月 ,平均 (45 .8± 11.7)个月 ,分析三组临床资料及治疗效果。 结果 第 1组 1、3、5年生存率分别为 83%、75 %、5 8% ,平均生存期 (48.5± 6 .7)个月、半数生存期 (37± 13.2 )个月 ,均高于 2、3组。生存曲线比较 ,1组与 2、3组差别有显著性意义 (P <0 .0 5 ) ,2、3组之间比较差别无显著性意义 (P >0 .0 5 )。第 3组中出现病理性骨折和截瘫各 1例。 结论 肾癌骨转移患者除实施辅助性肾切除 +辅助性治疗外 ,有指征的针对骨转移病灶进行手术可提高肾癌骨转移患者的生存期或生存质量。
Objective To study the characteristics of renal cell carcinoma(RCC) with bone metastasis and to evaluate the effect of treatment. Methods 26 patients of RCC with bone metastasis underwent nephrectomy prior to systemic therapy were divided into three groups:(1)12 patients with a solitary bone metastasis were referred for curative surgical treatment.(2)surgery was performed in 8 patients with multiple bone metastasis.(3)5 patients received systemic therapy alone.Clinical data were analyzed and all patients were followed up for 45.8±11.7 months. Results The 1 year,3 year,5 year survival rate and the average survival period of first group was higher than the second and the third group.The survival time of the second and the third group was similar( P >0.05),whereas there was a significant difference for the first group ( P <0.05). Conclusions In RCC patients with bone metastasis,nephrectomy and immunotherapy have proved to be effective.Surgical procedure in situs for bone metastasis should be performed for some selective patients in order to improve the long term result.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2002年第5期288-290,共3页
Chinese Journal of Urology
关键词
肾癌
骨转移
治疗
肾肿瘤
肿瘤转移
Kidney neoplasms
Neoplasm metastasis
Bones
Therapeutics
