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肾细胞癌的实际管理:将当前方法与骨转移治疗进展相结合。

Practical management of renal cell carcinoma: integrating current approaches with advances in bone metastasis treatment.

作者信息

Eremia Irina-Anca, Serban Bogdan, Popa Mihnea, Iancu Adela, Nica Silvia, Cirstoiu Catalin

机构信息

Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.

Department of Emergency Medicine, Emergency University Hospital, Bucharest, Romania.

出版信息

EFORT Open Rev. 2024 Jun 3;9(6):488-502. doi: 10.1530/EOR-23-0178.

Abstract

Renal cell carcinoma (RCC) is a common type of tumor that can develop in the kidney. It is responsible for around one-third of all cases of neoplasms. RCC manifests itself in a variety of distinct subtypes. The most frequent of which is clear cell RCC, followed by papillary and chromophobe RCC. RCC has the potential for metastasis to a variety of organs; nevertheless, bone metastases are one of the most common and potentially fatal complications. These bone metastases are characterized by osteolytic lesions that can result in pathological fractures, hypercalcemia, and other complications, which can ultimately lead to a deterioration in quality of life and an increase morbidity. While nephrectomy remains a foundational treatment for RCC, emerging evidence suggests that targeted therapies, including tyrosine kinase inhibitors and T cell checkpoint inhibitors, may offer effective alternatives, potentially obviating the need for adjuvant nephrectomy in certain cases of metastatic RCC Bone metastases continue to be a difficult complication of RCC, which is why more research is required to enhance patient outcome.

摘要

肾细胞癌(RCC)是一种可在肾脏发生的常见肿瘤类型。它约占所有肿瘤病例的三分之一。肾细胞癌表现为多种不同的亚型。其中最常见的是透明细胞肾细胞癌,其次是乳头状和嫌色性肾细胞癌。肾细胞癌有可能转移至多种器官;然而,骨转移是最常见且可能致命的并发症之一。这些骨转移的特征是溶骨性病变,可导致病理性骨折、高钙血症和其他并发症,最终可导致生活质量下降和发病率增加。虽然肾切除术仍然是肾细胞癌的基础治疗方法,但新出现的证据表明,包括酪氨酸激酶抑制剂和T细胞检查点抑制剂在内的靶向治疗可能提供有效的替代方案,在某些转移性肾细胞癌病例中可能无需进行辅助肾切除术。骨转移仍然是肾细胞癌的一种棘手并发症,这就是为什么需要更多研究来改善患者预后的原因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e7f/11195343/bd14ff2a1188/EOR-23-0178fig1.jpg

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