Department of Genitourinary Medical Oncology, M.D. Anderson Cancer Center, Houston, TX 77030, USA.
Am J Clin Oncol. 2013 Jun;36(3):258-60. doi: 10.1097/COC.0b013e3182467b9a.
To assess the response of brain metastases to sunitinib in patients with renal cell carcinoma (RCC) who did not undergo prior surgical resection or radiation to the brain.
We retrospectively reviewed the medical records of adult RCC patients who had metastases to the brain and received sunitinib.
Six patients with clear-cell RCC were identified between March 2006 and August 2009. All patients had ≥3 metastatic sites including the brain. Five patients received upfront sunitinib; 1 received sorafenib followed by sunitinib. Four patients had a solitary brain lesion, 1 patient had 2 lesions, and 1 patient had multiple subcentimeter lesions with the largest measuring 1.5 cm. Two patients achieved a near complete response to therapy with sunitinib and continue on treatment without recurrence in the brain for 47 and 23 months. One patient died of systemic disease without relapse in the brain. Two patients had disease progression in the brain and were salvaged with radiation therapy. One patient progressed systemically and in the brain after initial improvement in the brain.
Clear-cell RCC patients with small asymptomatic supratentorial metastases without hemorrhage or herniation safely received sunitinib as initial therapy with good response.
评估未经手术切除或脑部放疗的肾细胞癌（RCC）患者脑转移对舒尼替尼的反应。
我们回顾性分析了 2006 年 3 月至 2009 年 8 月间接受舒尼替尼治疗的脑转移 RCC 成年患者的病历。
共确定了 6 例透明细胞 RCC 患者。所有患者均有≥3 个包括脑部在内的转移灶。5 例患者接受了舒尼替尼的初始治疗；1 例接受了索拉非尼，然后接受了舒尼替尼。4 例患者有孤立性脑病变，1 例有 2 个病变，1 例有多个亚厘米病变，最大的为 1.5 厘米。2 例患者对舒尼替尼治疗有接近完全的反应，继续治疗，脑部未复发，分别持续了 47 个月和 23 个月。1 例患者死于全身疾病，脑部未复发。2 例患者脑内疾病进展，通过放疗挽救。1 例患者在脑部疾病最初改善后，出现全身和脑部进展。
无出血或脑疝的小的无症状幕上转移的透明细胞 RCC 患者安全地接受舒尼替尼作为初始治疗，反应良好。
