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目的比较索拉非尼治疗晚期肝细胞癌、肾癌疗效与不良反应的区别。方法观察2006年2月～2012年12月,索拉非尼治疗晚期肝细胞癌83例、晚期肾癌44例(透明细胞癌32例,乳头状癌12例)的疗效与不良反应。索拉非尼起始剂量400 mg/次口服,2次/d,至少用药4周以上,每4周复查CT评价疗效,根据不良反应调整剂量。结果索拉非尼治疗肾癌的客观缓解率、疾病控制时间等疗效指标均优于肝癌;肝癌患者使用索拉非尼的手足皮肤反应、腹泻、乏力、皮疹等副反应发生率更高;高血压、白细胞下降、脱发等发生率及严重程度相近。在肝癌患者中,27例因不良反应短时调整剂量,最终16例永久下调剂量或停药。肾癌患者仅4例因不良反应暂时停药但不久即恢复原剂量,8例患者因疾病进展而增加剂量。结论索拉非尼治疗肝癌的不良反应较肾癌严重,原因有待进一步研究。
Objective To compare the difference between sorafenib treatment of advanced hepatocellular carcinoma and renal cell carcinoma and adverse reactions. Methods From February 2006 to December 2012, 83 cases of advanced hepatocellular carcinoma and 44 cases of advanced renal cell carcinoma (32 cases of clear cell carcinoma and 12 cases of papillary carcinoma) were treated with sorafenib. The initial dose of sorafenib 400 mg / orally, 2 times / d, at least for more than 4 weeks, review the evaluation of CT every 4 weeks, according to adverse reactions to adjust the dose. Results Sorafenib treatment of renal cell carcinoma objective response rate, disease control time and other indicators of efficacy are superior to liver cancer; liver cancer patients with sorafenib foot and skin reactions, diarrhea, fatigue, rash and other side effects were higher; high Blood pressure, leukopenia, hair loss rates and the severity of similar. In patients with liver cancer, 27 patients with short-term adjustment for adverse reactions due to dose, the final 16 cases of permanent dose reduction or withdrawal. Only 4 patients with renal cancer were temporarily discontinued due to adverse reactions but soon returned to their original dose, and 8 patients were dosed with the disease due to disease progression. Conclusion Sorafenib treatment of liver cancer adverse reactions than renal cell carcinoma, the reasons for further study.