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目的:评价转移性肾癌索拉非尼治疗失败后联合吉西他滨+替吉奥化疗的疗效及毒副作用。方法:对10例索拉非尼治疗失败的转移性肾癌患者联合间歇化疗。化疗方案为吉西他滨1.0g/m2×1、8d+替吉奥0.5bid×1~14d,每21天为1个周期,首轮4周期后化疗间歇性重复进行。化疗同时继续口服索拉非尼400mg bid,直至治疗失败或患者不能耐受。观察治疗效果及毒副作用。结果:全部10例患者总体反应率(ORR)100%,中位无疾病进展时间(PFS)11个月,中位总生存时间(OS)20个月。毒副反应主要为Ⅱ~Ⅲ度骨髓抑制和消化道反应。结论:转移性肾癌酪氨酸激酶抑制剂(TKI)治疗失败后联合吉西他滨+替吉奥间歇化疗安全有效,值得进一步探索。
OBJECTIVE: To evaluate the efficacy and side effects of gemcitabine combined with ticio-chemotherapy after failure of sorafenib in patients with metastatic renal cell carcinoma. Methods: Ten patients with metastatic renal cell carcinoma who had failed sorafenib treatment were treated with intermittent chemotherapy. Chemotherapy regimen for gemcitabine 1.0g / m2 × 1, 8d + for gio 0.5bid × 1 ~ 14d, every 21 days for a period of 4 cycles after the first round of chemotherapy repeated intermittently. Chemotherapy continues with oral sorafenib 400 mg bid until treatment fails or the patient can not tolerate. To observe the therapeutic effect and side effects. RESULTS: All 10 patients had an overall response rate (ORR) of 100%, median progression-free time (PFS) of 11 months, and median overall survival time (OS) of 20 months. Toxic and side effects mainly Ⅱ ~ Ⅲ degree bone marrow suppression and gastrointestinal reactions. Conclusion: The combination of gemcitabine and tegaserod intermittent chemotherapy after the failure of metastatic renal cell carcinoma tyrosine kinase inhibitor (TKI) is safe and effective, which is worth further exploration.