论文部分内容阅读
目的 :探讨依维莫司治疗转移性肾细胞癌相关口腔炎的发生情况及其影响因素。方法 :回顾性分析28例服用依维莫司的晚期肾细胞癌患者的临床资料,评价口腔炎相关指标,并分析其影响因素。结果 :口腔炎总发生率为57.14%(16/28),严重口腔炎(Ⅲ/Ⅳ度)发生率为7.14%(2/28);10.71%(3/28)的患者因口腔炎而减少依维莫司剂量或停止依维莫司治疗。口腔炎发生的中位时间为服药后9.5 d(95%可信区间:1.0~36.5 d),口腔炎的中位持续时间为31.0 d(95%可信区间:22.1~61.8 d)。单因素分析结果显示,年龄≥60岁患者的口腔炎总发生率显著高于<60岁的患者(P=0.044);多因素分析显示,年龄对口腔炎的影响无统计学意义(P=0.999)。肾癌组织中磷酸化蛋白激酶B表达阳性患者的口腔炎发生率明显高于p-Akt表达阴性患者(P=0.048)。口腔炎严重程度与依维莫司相关PFS之间无明显相关性(P=0.190)。结论 :口腔炎(尤其是在老年患者中)的发生率较高。肾癌组织中磷酸化蛋白激酶B的表达水平可能是口腔炎的预测因子,而口腔炎可能不是依维莫司相关无进展生存的预测因子。
Objective: To investigate the occurrence and the influencing factors of everolimus in the treatment of metastatic renal cell carcinoma associated stomatitis. Methods: The clinical data of 28 patients with advanced renal cell carcinoma who took everolimus were retrospectively analyzed. The related indexes of stomatitis were evaluated and the influencing factors were analyzed. Results: The total incidence of stomatitis was 57.14% (16/28), severe stomatitis (Ⅲ / Ⅳ) was 7.14% (2/28), while 10.71% (3/28) was decreased due to stomatitis Everolimus dose or stop everolimus treatment. The median duration of stomatitis was 9.5 days (95% confidence interval: 1.0-36.5 days) and stomatitis with a median duration of 31.0 days (95% confidence interval: 22.1-61.8 days). Univariate analysis showed that the overall incidence of stomatitis was significantly higher in patients over 60 years of age than in patients <60 years (P = 0.044). Multivariate analysis showed that age had no significant effect on stomatitis (P = 0.999 ). The incidence of stomatitis in patients with positive expression of phosphorylated protein kinase B in renal cell carcinoma was significantly higher than that in patients with negative p-Akt expression (P = 0.048). There was no significant correlation between the severity of stomatitis and everolimus-associated PFS (P = 0.190). Conclusions: The incidence of stomatitis, especially in elderly patients, is high. The expression of phosphorylated protein kinase B in renal cell carcinoma may be a predictor of stomatitis, and stomatitis may not be a predictor of progression-free survival associated with everolimus.