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[摘要]
目的:比较阿昔替尼与索拉非尼一线治疗晚期肾癌的临床疗效,探讨分子靶向药物阿昔替尼能否作为一线治疗晚期肾癌的优选药物。 方法: 选取海口市人民医院肿瘤科60例晚期肾癌患者,以数字表法随机分为试验组和对照组,每组30例。实验组给予阿昔替尼,对照组给予索拉非尼治疗,比较两组患者的DCR、ORR、PFS、OS及不良反应的差异。 结果: 两组患者均能完成试验并进行结果评价。试验组和对照组的DCR分别为83.33%和80.00%、ORR分别为20.00%和20.00%,差异均无统计学意义( P >0.05);试验组和对照组的中位PFS分别为12.8个月和10.1个月,差异有统计学意义( P <0.05);中位OS分别为22.2个月和22.8个月,差异无统计学意义( P >0.05)。两组患者不良反应发生率相近,差异无统计学意义( P >0.05),主要表现在高血压、全身反应、手足皮肤综合征、消化道反应、肝功能损害,未见严重不良反应。 结论: 分子靶向药物阿昔替尼较索拉非尼一线治疗晚期肾癌更能延长患者中位PFS,两药治疗后患者的DCR、ORR、OS及不良反应相似,阿昔替尼可以作为一线治疗晚期肾癌的优选。
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[Abstract]
Objective: To compare the clinical efficacy of axitinib and sorafenib as first-line treatment for advanced renal cell carcinoma, and to explore whether axitinib could be used as a preferred first-line drug for advanced renal cell carcinoma. Methods: Sixty patients with advanced renal cell carcinoma from Haikou Municipal Hospital were enrolled in this study and divided into experimental group (n=30) and control group (n=30) according to a random number table. The experimental group received axitinib treatment and the control group received sorafenib treat-ment. Disease control rate (DCR), objective response rate (ORR), progression free survial (PFS), overall survival (OS), and adverse effects were evaluated and compared between two groups. Results: All patients in the two groups completed the experiment. There was no difference between the experimental group and the control group in DCR (83.33% vs 80.00% , P>0.05) and ORR (20.00% vs 20.00% , P>0.05). Significant difference in median PFS was found between the two groups (12.8 months of experimental group vs 10.1 months of control group, P<0.05);however, there was no significant difference in the median OS between two groups (22.2 months vs 22.8 months, P>0.05). The incidence of adverse reactions in the two groups was similar, mainly including hypertension, systemic re-actions, hand foot skin syndrome, digestive system reaction and liver function damage (P>0.05). No serious ad-verse effects were observed in both groups. Conclusion: Compared with sorafenib, axitinib significantly prolonged the median PFS in patients with advanced renal cell carcinoma, although the diseasecontrol rate, objective efficien-cy, overall survival, and adverse effects of two treatment regimen were comparable. Axitinib, the molecular targeted agent, can be used as a preferred first-line therapy for advanced renal cell carcinoma.
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