摘要
目的：探讨抗血管生成酪氨酸激酶抑制剂（ VEGFR-TKI）治疗过程中出现手足皮肤反应与疗效之间的关系。方法回顾性分析2006年1月至2014年1月中国医学科学院肿瘤医院收治的155例转移性肾细胞癌（ mRCC）患者的临床资料，所有患者均接受一线VEGFR-TKI治疗，比较其中出现手足皮肤反应患者与无手足皮肤反应患者的疗效及预后。治疗有效率比较采用χ2检验，生存分析应用Kaplan-Meier法，检验水准为α＝0.05。结果全组155例晚期肾细胞癌患者中位生存期36.2个月。出现手足皮肤反应117例（75.5％），其中1度19例（12.3％），2度73例（47.1％），3度25例（16.1％），无4度不良反应。无手足皮肤反应的患者治疗有效率为15.8％，中位无进展生存期（ mPFS）为6.7个月；出现手足皮肤反应的患者治疗有效率为52.1％，mPFS为13.8个月，二者间有效率（P＜0.001）和mPFS（P＝0.002）差异均有统计学意义。1度手足皮肤反应的患者治疗有效率为42.1％，mPFS为9.5个月，2度手足皮肤反应的患者治疗有效率为56.2％，mPFS为12.2个月，3度手足皮肤反应的患者治疗有效率为48.0％，mPFS为22.2个月，不同程度间治疗有效率及mPFS比较差异均有统计学意义（ P＝0.001、0.009）。结论在接受VEGFR-TKI治疗的mRCC中出现手足皮肤反应可能是药物治疗有效的预测因素，其结果有待大样本试验进一步证实。
Objective To investigate the association between hand-foot skin reaction （ HFSR） in the treatment with vascular endothelial growth factor receptor tyrosine kinase inhibitors （VEGFR-TKIs） and the effectiveness of VEGFR-TKIs.Methods Clinical data of 155 patients with metastatic renal cell carcinoma （ mRCC ） treated with VEGFR-TKIs at the Cancer Hospital of Chinese Academy of Medical Sciences between January 2006 and January 2014 were retrospectively analyzed.All the patients received first-line VEGFR-TKI therapy.The treatment effectiveness and outcome between patients developing HFSR and those without HFSR were compared.Comparison of treatment response rate （ RR） was performed with χ2 test, survival analysis was performed using Kaplan-Meier method, with a significance level of 0.05.Results The median survival of all the 155 patients was 36.2 months.Among the 117 （ 75.5%） patients who developed HFSR , 19 patients （ 12.3%） had grade Ⅰ HFSR, 73 （ 47.1%） had grade Ⅱ, and 25 （16.1%） had grade Ⅲ; there were no grade Ⅳ events.The RR and median progression-free survival （mPFS） in patients who did not develop HFSR were 15.8% and 6.7 months, respectively; while the RR and mPFS in patients who developed HFSR were 52.1% and 13.8 months, respectively （ P〈0.001, P=0.002）.The RR and mPFS in patients with grade Ⅰ HFSR were 42.1% and 9.5 months, respectively;those in patients with grade ⅡHFSR were 56.2%and 12.2 months, respectively, in patients with grade Ⅲwere 48.0%and 22.2 months, respectively, with statistically significant differences among the three grades of HFSR （ P=0.001, 0.009 ）.Conclusions HFSR might be an effective predictor for effectiveness of＆amp;nbsp;VEGFR-TKIs in mRCC patients.Large-sample studies are warranted to further prove these results.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2016年第34期2717-2721,共5页
National Medical Journal of China
关键词
癌
肾细胞
酪氨酸激酶抑制剂
手足皮肤反应
预测
Carcinoma,renal cell
Tyrosine kinase inhibitor
Hand-foot skin reaction
Prediction
