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目的:比较阿昔替尼与索拉非尼一线治疗晚期肾癌的临床疗效,探讨分子靶向药物阿昔替尼能否作为一线治疗晚期肾癌的优选药物。方法:选取海口市人民医院肿瘤科60例晚期肾癌患者,以数字表法随机分为试验组和对照组,每组30例。实验组给予阿昔替尼,对照组给予索拉非尼治疗,比较两组患者的DCR、ORR、PFS、OS及不良反应的差异。结果:两组患者均能完成试验并进行结果评价。试验组和对照组的DCR分别为83.33%和80.00%、ORR分别为20.00%和20.00%,差异均无统计学意义(P>0.05);试验组和对照组的中位PFS分别为12.8个月和10.1个月,差异有统计学意义(P<0.05);中位OS分别为22.2个月和22.8个月,差异无统计学意义(P>0.05)。两组患者不良反应发生率相近,差异无统计学意义(P>0.05),主要表现在高血压、全身反应、手足皮肤综合征、消化道反应、肝功能损害,未见严重不良反应。结论:分子靶向药物阿昔替尼较索拉非尼一线治疗晚期肾癌更能延长患者中位PFS,两药治疗后患者的DCR、ORR、OS及不良反应相似,阿昔替尼可以作为一线治疗晚期肾癌的优选。
OBJECTIVE: To compare the clinical efficacy of axitinib with sorafenib in the treatment of advanced renal cell carcinoma and to explore whether the molecularly targeted drug axitinib can be used as the first-line drug in the treatment of advanced renal cell carcinoma. Methods: Sixty patients with advanced renal cell carcinoma of the Haikou Peoples Hospital were enrolled and randomly divided into experimental group and control group with digital meter method, with 30 cases in each group. The experimental group was assigned to axitinib, and the control group was given sorafenib. The differences of DCR, ORR, PFS, OS and adverse reactions between the two groups were compared. Results: Both groups of patients completed the test and evaluated the results. The DCR of the experimental group and the control group were 83.33% and 80.00% respectively, with ORRs of 20.00% and 20.00%, respectively, with no significant difference (P> 0.05). The median PFS of the experimental group and the control group were 12.8 months And 10.1 months respectively (P <0.05). The median OS was 22.2 months and 22.8 months respectively, with no significant difference (P> 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). The main adverse reactions were hypertension, systemic reaction, hand-foot skin syndrome, digestive tract reaction and liver dysfunction. No serious adverse reactions were found. CONCLUSIONS: The targeted drug axitinib is more effective than sorafenib in first-line treatment of advanced renal cell carcinoma patients to extend the median PFS, two patients after treatment of DCR, ORR, OS and adverse reactions similar to axitinib can be used as First-line treatment of advanced renal cancer preferred.