论文部分内容阅读
目的:分析及研究靶向药物治疗肾癌并肾静脉癌栓后腹腔镜治疗的可行性、有效性和安全性。方法:2010年12月～2012年2月对4例单侧肾癌并肾静脉癌栓(无远处及局部淋巴结转移)患者先行靶向药物治疗3～6个月,其中3例使用苹果酸舒尼替尼(索坦),1例使用甲苯磺酸索拉非尼(多吉美);对照靶向治疗前后影像学检查并相继行后腹腔镜下肾癌根治性切除术,其中1例行后腹腔镜下腔静脉阻断癌栓取出术。结果:4例患者手术均获得成功,无中转开放手术。4例患者术后继续常规剂量服用靶向药物,并每3个月复查胸部及肾脏CT。结论:外科手术与靶向药物相结合的治疗手段代表肾癌并肾静脉癌栓患者最佳的选择方案,因为单纯靶向药物和单纯外科手术已经无法满足预后及生存率的真正需求。
OBJECTIVE: To analyze and study the feasibility, efficacy and safety of targeted drugs for laparoscopic treatment of renal cell carcinoma and renal vein tumor thrombus. Methods: From December 2010 to February 2012, 4 patients with unilateral renal cell carcinoma and renal vein tumor thrombus (without distant and local lymph node metastasis) were treated with targeted drug for 3 to 6 months. Three of them were treated with malic acid Sunitinib (Sultan), 1 case of sorafenib tosylate (Doji and the United States); control before and after targeted radiotherapy and postoperative laparoscopic radical nephrectomy, of which 1 case Retroperitoneal laparoscopic venous occlusion of thrombus removed. Results: All the 4 patients were successful in operation. There was no transfer to open surgery. Four patients continued to receive regular doses of targeted drugs after surgery, and chest and kidney CT were reviewed every three months. CONCLUSIONS: The combination of surgery and targeted therapy represents the best option for patients with renal cell carcinoma and renal vein thrombus because simple targeted drugs and simple surgeries have failed to meet the real need for prognosis and survival.