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[手足皮肤反应与血管内皮生长因子受体酪氨酸激酶抑制剂对转移性肾细胞癌患者疗效的相关性]

[Association between hand-foot skin reaction and effectiveness of vascular endothelial growth factor receptor tyrosine kinase inhibitors in patients with metastatic renal cell carcinoma].

作者信息

Song Y, Du C X, Zhang W, Sun Y K, Yang L, Cui C X, Yihebali Chi, Zhou A P, Wang J W, Sun Y

机构信息

Department of Medical Oncology, Cancer Hospital and Institute, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100021, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2016 Sep 13;96(34):2717-2721. doi: 10.3760/cma.j.issn.0376-2491.2016.34.006.

Abstract

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. 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 χ test, survival analysis was performed using Kaplan-Meier method, with a significance level of 0.05. 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 (<0.001, =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 Ⅱ HFSR were 56.2% and 12.2 months, respectively, in patients with grade Ⅲ were 48.0% and 22.2 months, respectively, with statistically significant differences among the three grades of HFSR (=0.001, 0.009). HFSR might be an effective predictor for effectiveness of VEGFR-TKIs in mRCC patients. Large-sample studies are warranted to further prove these results.

摘要

探讨血管内皮生长因子受体酪氨酸激酶抑制剂(VEGFR-TKIs)治疗过程中手足皮肤反应(HFSR)与VEGFR-TKIs疗效之间的关联。回顾性分析了2006年1月至2014年1月在中国医学科学院肿瘤医院接受VEGFR-TKIs治疗的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。比较了发生HFSR的患者与未发生HFSR的患者的治疗效果和预后。采用χ检验比较治疗缓解率(RR),采用Kaplan-Meier法进行生存分析,显著性水平为0.05。155例患者的中位生存期为36.2个月。在发生HFSR的117例(75.5%)患者中,19例(12.3%)为Ⅰ级HFSR,73例(47.1%)为Ⅱ级,25例(16.1%)为Ⅲ级;无Ⅳ级事件。未发生HFSR的患者的RR和中位无进展生存期(mPFS)分别为15.8%和6.7个月;而发生HFSR的患者的RR和mPFS分别为52.1%和13.8个月(<0.001,=0.002)。Ⅰ级HFSR患者的RR和mPFS分别为42.1%和9.5个月;Ⅱ级HFSR患者分别为56.2%和12.2个月,Ⅲ级患者分别为48.0%和22.2个月,HFSR的三个等级之间差异有统计学意义(=0.001,0.009)。HFSR可能是mRCC患者VEGFR-TKIs疗效的有效预测指标。需要大样本研究进一步证实这些结果。

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