Department of Urology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
Int J Urol. 2012 Oct;19(10):908-13. doi: 10.1111/j.1442-2042.2012.03071.x. Epub 2012 Jun 6.
To investigate the prognostic role of C-reactive protein in patients with advanced renal cell carcinoma treated with sunitinib.
A total of 41 consecutive patients with advanced clear-cell renal cell carcinoma treated with sunitinib between December 2008 and August 2011 were included in this study. Logistic regression analysis estimated the relative importance of non-tumor variables, including C-reactive protein, and selected adverse events as predictive factors for sunitinib responses.
Overall, 11 patients (26.8%) showed a partial response and 10 patients (24.4%) had stable disease. On univariate analysis, Memorial Sloan-Kettering Cancer Center non-poor risk, normal C-reactive protein, hand-foot skin reaction, altered taste, fatigue and leukopenia were significantly correlated with objective responses (P = 0.020, 0.001, 0.006, 0.006, 0.023 and 0.037, respectively). On multivariate analysis, normal C-reactive protein was independently associated with objective response (P = 0.016). Patients with a normal level of C-reactive protein (≤0.30 mg/dL) had a significantly higher partial response plus stable disease rate (84.6% vs 35.7%, P = 0.002) and significantly longer progression-free survival (median 19.0 vs 6.0 months, P = 0.036) than patients with an elevated level of C-reactive protein.
C-reactive protein is an independent prognostic indicator for patients with advanced renal cell carcinoma treated with sunitinib.
探讨 C 反应蛋白在接受舒尼替尼治疗的晚期肾细胞癌患者中的预后作用。
本研究共纳入 2008 年 12 月至 2011 年 8 月期间接受舒尼替尼治疗的 41 例连续晚期透明细胞肾细胞癌患者。逻辑回归分析估计非肿瘤变量（包括 C 反应蛋白）和选定不良事件作为舒尼替尼反应预测因素的相对重要性。
总体而言，11 例患者（26.8%）出现部分缓解，10 例患者（24.4%）病情稳定。单因素分析显示，纪念斯隆-凯特琳癌症中心非贫困风险、正常 C 反应蛋白、手足皮肤反应、味觉改变、乏力和白细胞减少与客观反应显著相关（P = 0.020、0.001、0.006、0.006、0.023 和 0.037）。多因素分析显示，正常 C 反应蛋白与客观反应独立相关（P = 0.016）。C 反应蛋白水平正常（≤0.30mg/dL）的患者部分缓解加稳定疾病的发生率明显更高（84.6%比 35.7%，P = 0.002），无进展生存期明显更长（中位 19.0 个月比 6.0 个月，P = 0.036）。
C 反应蛋白是接受舒尼替尼治疗的晚期肾细胞癌患者的独立预后指标。
