冷冻消融联合索拉菲尼治疗转移性肾癌的初步临床研究

张立进; 张士伟; 郭宏骞

doi:10.13201/j.issn.1001-1420.2015.05.010

冷冻消融联合索拉菲尼治疗转移性肾癌的初步临床研究

- 南京大学医学院附属鼓楼医院泌尿外科(南京, 210008)

详细信息

通讯作者: 郭宏骞,E-mail:dr.guohongqian@gmail.com

中图分类号: R737.11

收稿日期: 2014-11-14

Initial clinical study of cryoablation combined with sorafenib in the treatment for metastatic renal cell carcinoma

- Department of Urology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210008, China

More Information

Corresponding author: GUO Hongqian, E-mail: dr.guohongqian@gmail.com

Received Date: 14 November 2014

摘要

摘要: 目的：初步研究冷冻消融（氩氦刀）联合口服索拉菲尼治疗转移性肾癌的临床效果。方法：回顾性分析我院2010年10月~2012年3月收治的9例肾癌伴远处转移患者的临床资料：男7例，女2例，年龄43~71岁，平均58岁。9例肾癌伴肺部转移患者中，双侧多发肺转移伴右侧肱骨转移1例，左侧肺转移5例，右肺转移3例。所有患者均先行根治性肾切除术，2周后再于局部麻醉下行转移灶冷冻治疗，然后口服索拉菲尼进行治疗。结果：9例患者手术均获得成功。肺部转移病灶完全损毁7例，术后4例出现少量咳血，对症处理后缓解；1例术后1周出现大量胸腔积液，予以放置闭氏引流后积液消失，右肱骨转移灶冷冻术后患肢未见明显异常，2周后恢复正常功能。患者术后口服索拉菲尼，药物耐受性及肿瘤控制均取得较满意效果。9例患者随访6~21个月，平均15个月。1例肾癌伴下腔静脉癌栓，左肺转移患者术后13个月死于肿瘤转移，2例肺部多发转移患者分别于术后12、16个月死于肿瘤进展，其余患者均存活。结论：转移性肾癌愈后差，冷冻治疗转移灶后联合索拉菲尼进行治疗可提高患者的生存时间。但由于病例数较少，仍需积累更多相关例数，进一步随诊观察。
- 转移性肾癌 /
- 冷冻消融 /
- 索拉菲尼
Abstract: Objective: To preliminarily observe the clinical effect of cryosurgery (argon-helium knife) combined with sorafenib on the patients with metastatic renal cell carcinoma.Method: From October 2010 to March 2012, nine patients including seven males and two females were treated for renal cell carcinoma. The average patients' age was 58 (range, 43-71) years old. Of them, one case was found bilateral multiple pulmonary metastasis combined with right side of humerus metastasis, five cases were diagnosed as left lung cancer metastasized from renal cell carcinoma, and right lung cancer metastasized from renal cell carcinoma was found in other three cases. All patients were treated with sorafenib after radical nephrectomy combined with cryoablation for bone and lung metastases under the local anesthesia.Result: Cryoablation was technically successful in all nine patients. The metastatic lesions of pulmonary in seven cases was completely damaged. Four patients had postoperative symptoms of hemoptysis, and the symptoms disappeared after the symptomatic treatment. One case experienced massive pleural effusion at the first week after cryosurgery, and the symptom vanished after the closed chest drainage. The patient with bone metastases returned to normal function after cryoablation in the right humerus for two weeks. All patients were sensitive to sorafenib and showed good clinical effects. All patients were followed up for 6-21 (mean, 15) months. One case of renal cancer accompanied by inferior vena cava tumor thrombus migrating to the left lung and two patients with lung multiple tumor metastasis died 13, 12 and 16 months postoperatively respectively. The rest patients still survived.Conclusion: The prognosis of metastatic renal cell carcinoma is poor. Cryotherapy combined with the treatment of sorafenib for metastatic renal cell carcinoma can increase the survival of patients with advanced cancer. However, more relevant cases are needed to have a further observation.
- metastatic renal cell carcinoma /
- cryoablation /
- sorafenib

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