Denis L, Van Oosterom A
Department of Urology, Oncological Center Antwerp, A.Z. Middelheim, Belgium.
Semin Surg Oncol. 1988;4(2):91-4.
The appearance of metastatic disease heralds disaster for the vast majority of patients with renal carcinoma. A few spontaneous regressions of established metastases have been reported but no systemic chemotherapeutic treatment withstood the test of time or critical analysis. This analysis requires objective remissions in measurable metastatic disease evaluated against well-defined prognostic factors in relation to survival with quality of life for the patient. No single agent chemotherapy achieved a desired 20% response rate and only a few combination studies, especially with immunotherapy, reported significant clinical results. We recommend that the variable biological potential of renal metastatic disease be harnessed in prospective multicentric phase I/II trials with strict response and prognostic criteria to search for new antineoplastic agents for this disease.
转移性疾病的出现预示着绝大多数肾癌患者的灾难。虽然有少数已确诊转移灶自发消退的报道，但尚无任何全身化疗能经受住时间考验或严格分析。这种分析需要在针对与患者生存及生活质量相关的明确预后因素进行评估的可测量转移性疾病中实现客观缓解。单药化疗未达到预期的20%缓解率，只有少数联合治疗研究，特别是免疫治疗研究，报道了显著的临床结果。我们建议，在具有严格缓解和预后标准的前瞻性多中心I/II期试验中利用肾转移性疾病可变的生物学潜能，以寻找针对该疾病的新型抗肿瘤药物。
