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目的:探讨索拉非尼靶向治疗中、晚期肾细胞癌的临床效果及安全性。方法:收集2011年9月至2014年5月在我科室行肾细胞癌根治术或原发灶切除术等姑息性手术治疗的肿瘤直径≥7 cm,并术后经病理证实为中、晚期肾细胞癌,伴发转移病灶或静脉瘤栓的20例患者的临床资料。依据术后应用的辅助治疗方法将其分为索拉非尼靶向治疗组(8例)及干扰素免疫治疗组(12例),记录和比较两组患者的治疗效果、相关副反应的发生情况以及患者使用药物治疗后退出治疗的情况。结果:免疫治疗组的药物客观反应率(50%)低于较靶向治疗组(75%),总有效率(83.3%)亦低于靶向治疗组(87.5%),差异均无统计学意义(P>0.05)。与靶向治疗组相比,免疫治疗组患者发热、口腔黏膜炎、手足综合征及皮疹等副反应的几率明显增高(P<0.05)。免疫治疗组的患者退出治疗率明显高于靶向治疗组,组间比较差异具有统计学意义(P<0.05)。结论:采用索拉非尼靶向治疗中、晚期肾细胞癌的效果要优于免疫治疗,且安全性更高。
Objective: To investigate the clinical efficacy and safety of sorafenib in the treatment of advanced renal cell carcinoma. Methods: From September 2011 to May 2014, patients with palliative surgery such as radical nephrectomy or primary tumor excision were treated in our department. The diameter of the tumor was ≥7 cm. Pathological examination confirmed that the diameter of the tumor was middle and advanced stage The clinical data of 20 patients with cell carcinoma, metastatic lesions or venous thrombus. According to the postoperative adjuvant therapy, the patients were divided into sorafenib-targeted therapy group (n = 8) and interferon immunotherapy group (n = 12). The therapeutic effects and related side effects of the two groups were recorded and compared As well as the patient’s withdrawal from treatment after taking the drug. Results: The objective response rate (50%) in the immunotherapy group was lower than that in the targeted therapy group (75%) and the total effective rate (83.3%) was lower than that in the targeted therapy group (87.5%), with no statistical difference Significance (P> 0.05). Patients in the immunotherapy group had significantly higher risk of side effects such as fever, oral mucositis, hand-foot syndrome, and skin rashes compared with those in the targeted therapy group (P <0.05). The withdrawal rate of patients in immunotherapy group was significantly higher than that in the targeted therapy group, with significant difference between the two groups (P <0.05). Conclusion: Sorafenib targeted therapy in advanced renal cell carcinoma is better than immunotherapy, and more secure.