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评价索拉非尼在 75 岁及以上肾癌患者中的疗效和安全性:倾向评分匹配分析。

Evaluation of efficacy and safety of sorafenib in kidney cancer patients aged 75 years and older: a propensity score-matched analysis.

机构信息

Department of Urology, Graduate School of Medical Science, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka City, 812-8582, Japan.

Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.

出版信息

Br J Cancer. 2018 Jul;119(2):241-247. doi: 10.1038/s41416-018-0129-3. Epub 2018 Jun 12.

Abstract

BACKGROUND

The average age of patients diagnosed with renal cell carcinoma (RCC) is increasing, but a limited number of reports have described therapy of tyrosine kinase inhibitor for elderly RCC patients. Hence, we analysed the efficacy and safety of sorafenib in elderly patients aged ≥75 years with advanced RCC.

METHODS

Data were extracted from <75-year-old and ≥75-year-old patient groups, matching those demographics considered to affect prognosis. Differences in patients' characteristics, dose modification, adverse events, tumour response, progression-free survival, and renal function (glomerular filtration) were evaluated between the groups.

RESULTS

From 2536 and 703 patients aged <75 and ≥75 years, respectively, 397 pairs were matched. Median daily dose was higher and duration of treatment longer in patients <75 years; however, progression-free survival and tumour response were similar in both age groups. Incidence of all adverse events was not significantly different between groups. The proportion of patients discontinuing treatment was higher in patients ≥75 years, but there was no significant difference between groups in the number patients discontinuing due to adverse events.

CONCLUSIONS

For patients aged ≥75 years, sorafenib treatment had minimal additional negative impact compared to younger patients and showed similar efficacy and safety without reducing renal function.

摘要

背景

诊断为肾细胞癌(RCC)的患者平均年龄正在增加,但仅有少数报道描述了老年 RCC 患者使用酪氨酸激酶抑制剂的治疗方法。因此,我们分析了索拉非尼在年龄≥75 岁的晚期 RCC 老年患者中的疗效和安全性。

方法

从年龄<75 岁和≥75 岁的患者组中提取数据,匹配那些被认为影响预后的人口统计学特征。评估两组患者特征、剂量调整、不良事件、肿瘤反应、无进展生存期和肾功能(肾小球滤过率)的差异。

结果

分别从年龄<75 岁和≥75 岁的 2536 例和 703 例患者中匹配了 397 对。年龄<75 岁的患者每日中位剂量更高,治疗持续时间更长;然而,两组的无进展生存期和肿瘤反应相似。两组的所有不良事件发生率无显著差异。年龄≥75 岁的患者停药比例较高,但因不良事件停药的患者比例在两组间无显著差异。

结论

与年轻患者相比,对于年龄≥75 岁的患者,索拉非尼治疗的负面影响最小,且疗效和安全性相似,不会降低肾功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/412a/6048135/74aedb4dbce8/41416_2018_129_Fig1_HTML.jpg

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