Objective: To observe the clinical effect of sunitinib in patients with metastatic renal cell carcinoma (Renal Cell, MRCC) and its effect on the expression of survivin and telomerase. Methods: 66 cases of MRCC patients were selected as the research objects from January 2014 to November 2015 years in our hospital, and they were divided into EG and CG using random numeration table, 33 cases in each group. The patients in the control group were treated with IL-2 and IFNa-2a immunotherapy. The patients in the observation group were treated with sunitinib. Immunohistochemical method was used to detect the survivin and telomerase expression changes of the two groups before and after treatment. At the same time, their objective response rate, the total survival time, PFS and adverse reaction occurrence and ORR rates were observed and compared. Results: In the observation group, ORR was 27.3% (9/33), while it was 6.1% (2/33) in the control group, the difference between the two groups was significant (χ2=5.346, P<0.05). The total survival time and PFS of the observation group were significantly longer than those of the control group (P<0.05); compared with those before the treatment, the survival and telomerase of two groups of patients expression positive rates were significantly decreased and the positive rates of the observation group was significantly lower than the control group after the treatment (P<0.05). The adverse reactions of the two groups were compared, fever and fatigue were more common in the control group, abnormal taste, high blood pressure, skin and mucous membrane reaction, thyroid dysfunction, vomiting were seen in the observation group patients. There was no significant difference in the incidence of nausea, diarrhea, bone marrow suppression, liver function and other adverse reactions between the two groups (P> 0.05). Conclusion: The therapeutic effect of sunitinib treating MRCC is significant. it can effectively reduce the expression of telomerase and survivin, render a stable condition, improve the prognosis, improve the patient's survival rate and quality of life, also Most adverse/reactions can be tolerated, the safety is high, thus it is worthy of clinical application. |
[1] 张华锋,赵佳,刘新颖.转移性肾细胞癌靶向药物治疗长期疗效观察[J].医学研究生学报,2015,28(7):737-740.
[2] 崔传亮,李思明,迟志宏,等.舒尼替尼服药2周停药1周方案一线治疗转移性肾细胞癌患者的探索性研究[J].中华肿瘤杂志,2015,37(5):375-378.
[3] 赵菊平,何竑超,王浩飞,等.舒尼替尼治疗转移性肾癌的预后因素分析[J].中华泌尿外科杂志,2015,36(1):7-12.
[4] ALTHOFF K,LINDNER S, ODERSKY A, et al. miR-542-3p exerts tumor suppressive functions in neuroblastoma by down regulating survivin[J].Int J Cancer,2015,136(6):1308-1320.
[5] THERASSE P,ARBUCK S G,EISENHAUER E A,et a1. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada.[J]. Breast Cancer,2005,92(1):881-6.
[6] 顾伟杰,施国海,瞿元元,等.NLR-PLT评分在舒尼替尼治疗转移性肾癌患者中的应用[J].临床泌尿外科杂志,2015,30(2):120-123.
[7] 陈远,王毅,李建军,等.转移性肾癌生物治疗研究进展[J]. 现代生物医学进展,2013,13(13):2593-2596.
[8] 李景勤.肾细胞癌的治疗进展[J]. 国外医药:抗生素分册,2012,33(3):131-137.
[9] 辛航.舒尼替尼治疗晚期肾细胞癌的临床探讨[D].郑州大学,2012
[10] 祁兴顺,贾佳,韩国宏,等.舒尼替尼治疗肝细胞癌的临床研究现状[J]. 胃肠病学,2014,19(3):169-172.
[11] 张冬梅,肖永双,王侠.舒尼替尼治疗转移性肾癌的临床观察[J]. 中国现代医药杂志,2016,18(1):38-40.
[12] A SELLA, MD MICHAELSON, EM MATCZAK, et al. Heterogeneity of intermediate prognosis patients (pts) with metastatic renal cell cancer (mRCC) treated with sunitinib[J]. J Clin Oncol,2014,32(4):366-366.
[13] MENKO F H,MAHER E R, SCHMIDT L S,el a1.Hereditary leiomyomatosis and renal cell cancer(HLRCC):renal cancer risk,surveillance and treatment[J].Fam Cancer,2014,13(4):637-644.
[14] 胡凡果,只向成.史玉荣,等.人端粒酶逆转录酶shRNA抑制乳腺癌T470细胞增殖活性的研究[J].中华实验外科杂志,2013,30(4):667-670.
[15] 张磊,李小毅.端粒酶反转录酶启动子突变在甲状腺癌中的研究进展[J]. 癌症进展, 2015,13(4):391-395.
[16] 杜冰.乳腺癌患者术前中性粒细胞淋巴细胞比值(NLR)与预后的关系[D].大连医科大学,2014:33-35.
[17] 吴翔,李学松,何志嵩,等.舒尼替尼治疗转移性肾癌的进展[J]. 中华临床医师杂志:电子版,2012,6(3):97-100. |
