Anand Deepa, Escalante Carmen P
Department of General Internal Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Department of General Internal Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
J Pain Symptom Manage. 2015 Jul;50(1):108-17. doi: 10.1016/j.jpainsymman.2015.02.007. Epub 2015 Feb 18.
Renal cell carcinoma (RCC) represents 1% to 4% of adult malignancies, and approximately 33% of patients with RCC present with metastatic disease and have a poor prognosis. Better understanding of RCC tumor biology has led to the development of several molecularly targeted agents, such as tyrosine kinase inhibitors (TKIs), to manage advanced disease. Although evolving data suggest these drugs may be beneficial in RCC, they are associated with significant toxicities. Cancer-related fatigue (CRF) is one of the most common toxicities associated with the TKIs used in RCC.
To review the incidence, pathophysiology, and management of CRF in patients with RCC who are undergoing targeted therapy with TKIs.
A comprehensive database search was performed using PubMed, Ovid, Embase, and MEDLINE. References of all cited articles also were reviewed. Data from articles published between 1975 and June 2014 were considered. A narrative review regarding the incidence, pathophysiology, and management of CRF in patients with RCC undergoing targeted therapy with TKIs was performed.
CRF is one of the most common TKI toxicities in patients with metastatic RCC and often is the dose-limiting toxicity. Management of TKI-related CRF can be difficult and may necessitate various nonpharmacologic and pharmacologic interventions.
TKI-related CRF in patients with RCC is a highly distressing complication of cancer therapy. CRF can substantially influence drug compliance, the ability to maximally treat, and quality of life. It is important to recognize this common, yet frequently underdiagnosed complication and initiate appropriate management strategies, to increase the likelihood for optimal outcomes.
肾细胞癌（RCC）占成人恶性肿瘤的1%至4%，约33%的RCC患者出现转移性疾病，预后较差。对RCC肿瘤生物学的深入了解促使了几种分子靶向药物的研发，如酪氨酸激酶抑制剂（TKIs），用于治疗晚期疾病。尽管不断有数据表明这些药物可能对RCC有益，但它们也伴有显著的毒性。癌症相关疲劳（CRF）是RCC中使用的TKIs相关的最常见毒性之一。
综述接受TKIs靶向治疗的RCC患者中CRF的发生率、病理生理学及管理。
使用PubMed、Ovid、Embase和MEDLINE进行全面的数据库检索。还对所有引用文章的参考文献进行了审查。纳入1975年至2014年6月发表文章的数据。对接受TKIs靶向治疗的RCC患者中CRF的发生率、病理生理学及管理进行叙述性综述。
CRF是转移性RCC患者中最常见的TKIs毒性之一，且常为剂量限制性毒性。TKIs相关CRF的管理可能困难，可能需要各种非药物和药物干预措施。
RCC患者中TKIs相关CRF是癌症治疗中一种极为痛苦的并发症。CRF可显著影响药物依从性、最大治疗能力和生活质量。认识到这种常见但经常漏诊的并发症并启动适当的管理策略很重要，以增加获得最佳结果的可能性。
