晚期肾细胞癌多靶点药物新辅助及辅助治疗的临床研究.pdfVIP

上海交通大学医学院硕士学位论文 NEOADJUVANT AND ADJUVANT TARGETED THERAPY IN ADVANCED RENAL CELL CARCINOMA ABSTRACT Objective To evaluate postoperative complications after the use of neoadjuvant targeted therapy prior to nephrectomy. Methods A retrospective review of all patients who underwent nephrectomy at Ruijin Hospital from 2008 to 2011 was performed. Inclusion in this study required documented evidence of renal cell carcinoma with treatment incorporating nephrectomy. Patients receiving presurgical multi-targeted therapy prior to nephrectomy were compared to those receiving targeted therapy following nephrectomy. Complications were assessed using the modified Clavien system for a period of 12 months postoperatively. Results Presurgical neoadjuvant therapy was administered to 21 patients prior to nephrectomy (neoadjuvant), while 27 patients received targeted therapy following nephrectomy (adjuvant). The average tumor shrinkage was 14.8% (3.0-37.1%) after 4-8 weeks of targeted therapy. A total of 29 complications occurred in 44% of patients (21 of 48). Use of presurgical systemic targeted therapy was a risk factor of having a wound complication postoperatively in univariable analysis (p=0.018), but in 上海交通大学医学院硕士学位论文 multivariate analysis it was not significant (p=0.095). Despite wound complications, presurgical targeted therapy was not associated with an increased overall complication risk on univariable or multivariate analysis (p = 0.790 and p = 0.389) and was not predictive for severe (Clavien≥ 3) complications (p = 0.625). This study is limited by its retrospective nature and number of cases. As is inherent to any retrospective