Extracerebral metastases determine the outcome of patients with brain metastases from renal cell carcinoma.
Extracerebral metastases determine the outcome of patients with brain metastases from renal cell carcinoma.
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DOI：
10.1186/1471-2407-10-480
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发表时间：
2010-09-07
期刊：
影响因子：
3.8
通讯作者：
Schmidinger M
中科院分区：
文献类型：
--
作者：
Vogl UM;Bojic M;Lamm W;Frischer JM;Pichelmayer O;Kramer G;Haitel A;Kitz K;Harmankaya K;Zielinski CC;Schmidinger M
在细胞因子时代，肾细胞癌脑转移（BM）患者的生存期明显短于无脑转移的患者。靶向药物（TA）改善了转移性肾细胞癌（mRCC）患者的结局，但其对BM患者的影响尚不清楚。本分析的目的是比较靶向药物时代有和没有BM的患者的结果。分析了114例连续接受靶向药物治疗的患者的缓解率（ORR）、无进展生存期（PFS）和总生存期（OS）。所有诊断为BM的患者在开始药物治疗前均接受了局部BM特异性治疗。分析了114例连续使用至少一种靶向药物的患者的数据。114例肾细胞癌（RCC）患者中有12例（10.5%）被诊断为BM。全身治疗包括舒尼替尼、索拉非尼、替西罗莫司或贝伐珠单抗。BM患者和非BM患者的中位PFS分别为8.7个月（95% CI 5.1 - 12.3）和11.4个月（95% CI 8.7 - 14.1）（p = 0.232）。有和无BM患者的中位总生存期分别为13.4（95% CI 1- 43.9）和33.3个月（95% CI 18.6 - 47.0）（p = 0.358）。无患者死于脑疾病进展。ECOG体能状态和从原发肿瘤到转移的时间（TDM）是短生存期的独立风险因素（HR 2.74，p = 0.001; HR：0.552，p = 0.034）。虽然脑外转移决定了BM患者的预后，但与无BM患者相比，靶向药物的获益似乎仍然有限。
In the era of cytokines, patients with brain metastases (BM) from renal cell carcinoma had a significantly shorter survival than patients without. Targeted agents (TA) have improved the outcome of patients with metastatic renal cell carcinoma (mRCC) however, their impact on patients with BM is less clear. The aim of this analysis was to compare the outcome of patients with and without BM in the era of targeted agents. Data from 114 consecutive patients who had access to targeted agent were analyzed for response rates (ORR), progression free survival (PFS) and overall survival (OS). All patients diagnosed with BM underwent local, BM-specific treatment before initiation of medical treatment. Data of 114 consecutive patients who had access to at least one type of targeted agents were analyzed. Twelve out of 114 renal cell carcinoma (RCC) patients (10.5%) were diagnosed with BM. Systemic treatment consisted of sunitinib, sorafenib, temsirolimus or bevacizumab. The median PFS was 8.7 months (95% CI 5.1 - 12.3) and 11.4 months (95% CI 8.7 - 14.1) for BM-patients and non-BM-patients, respectively (p = 0.232). The median overall survival for patients with and without BM was 13.4 (95% CI 1- 43.9) and 33.3 months (95% CI 18.6 - 47.0) (p = 0.358), respectively. No patient died from cerebral disease progression. ECOG Performance status and the time from primary tumor to metastases (TDM) were independent risk factors for short survival (HR 2.74, p = 0.001; HR: 0.552, p = 0.034). Although extracerebral metastases determine the outcome of patients with BM, the benefit from targeted agents still appears to be limited when compared to patients without BM.
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影响因子：
8
作者：
Niu, GL;Wright, KL;Yu, H
通讯作者：
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影响因子：
11.2
作者：
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影响因子：
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作者：
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DOI：
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影响因子：
3.1
作者：
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通讯作者：
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影响因子：
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