C-reactive protein as a prognostic marker for advanced renal cell carcinoma treated with sunitinib
C-reactive protein as a prognostic marker for advanced renal cell carcinoma treated with sunitinib
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DOI：
10.1111/j.1442-2042.2012.03071.x
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发表时间：
2012-10-01
影响因子：
2.6
通讯作者：
Baba, Shiro
中科院分区：
文献类型：
--
作者：
Fujita, Tetsuo;Iwamura, Masatsugu;Baba, Shiro
目的：探讨C反应蛋白对舒尼替尼治疗晚期肾癌患者预后的影响。研究方法：本研究纳入了2008年12月至2011年8月期间接受舒尼替尼治疗的41例连续晚期透明细胞肾细胞癌患者。Logistic回归分析估计了非肿瘤变量（包括C反应蛋白）的相对重要性，并选择不良事件作为舒尼替尼反应的预测因素。结果：总体而言，11例患者（26.8%）显示部分缓解，10例患者（24.4%）病情稳定。在单变量分析中，Memorial Sloan-Kettering癌症中心非低风险、正常C反应蛋白、手足皮肤反应、味觉改变、疲劳和白细胞减少与客观缓解显著相关（分别为P = 0.020、0.001、0.006、0.006、0.023和0.037）。在多变量分析中，正常C反应蛋白与客观反应独立相关（P = 0.016）。与C反应蛋白水平升高的患者相比，C反应蛋白水平正常（=0.30 mg/dL）的患者的部分缓解加疾病稳定率（84.6% vs 35.7%，P = 0.002）和无进展生存期（中位数19.0 vs 6.0个月，P = 0.036）显著更高。结论：C反应蛋白是舒尼替尼治疗晚期肾癌患者的独立预后指标。
Objectives: To investigate the prognostic role of C-reactive protein in patients with advanced renal cell carcinoma treated with sunitinib. Methods: A total of 41 consecutive patients with advanced clear-cell renal cell carcinoma treated with sunitinib between December 2008 and August 2011 were included in this study. Logistic regression analysis estimated the relative importance of non-tumor variables, including C-reactive protein, and selected adverse events as predictive factors for sunitinib responses. Results: Overall, 11 patients (26.8%) showed a partial response and 10 patients (24.4%) had stable disease. On univariate analysis, Memorial Sloan-Kettering Cancer Center non-poor risk, normal C-reactive protein, handfoot skin reaction, altered taste, fatigue and leukopenia were significantly correlated with objective responses (P = 0.020, 0.001, 0.006, 0.006, 0.023 and 0.037, respectively). On multivariate analysis, normal C-reactive protein was independently associated with objective response (P = 0.016). Patients with a normal level of C-reactive protein (=0.30 mg/dL) had a significantly higher partial response plus stable disease rate (84.6% vs 35.7%, P = 0.002) and significantly longer progression-free survival (median 19.0 vs 6.0 months, P = 0.036) than patients with an elevated level of C-reactive protein. Conclusions: C-reactive protein is an independent prognostic indicator for patients with advanced renal cell carcinoma treated with sunitinib.