接受舒尼替尼治疗的老年转移性肾细胞癌患者的淋巴细胞减少及临床结局

Lymphopenia and clinical outcome of elderly patients treated with sunitinib for metastatic renal cell cancer
期刊: J Geriatric Oncology2014年1月期卷

Objective
Lymphopenia is associated with toxicity and outcomes in several cancer types. We assessed the association between pre-treatment lymphopenia, toxicity, and clinical outcomes in elderly patients with metastatic renal cell cancer (mRCC) treated with first-line sunitinib. Prognostic factors in these patients were also evaluated.

Patients and methods
We reviewed the clinical records of 181 patients with mRCC aged ≥ 70 years treated with first-line sunitinib in 17 Italian Oncology Units from February 2006 to September 2011. Baseline lymphopenia was defined as lymphocyte counts < 1000/μL.

Results
Twenty-nine (16%) patients had a baseline lymphocyte count < 1000/μL (group A) and 152 (84%) patients had a lymphocyte count ≥ 1000/μL (group B). Although no differences between the two groups were reported in terms of overall response rate (P = 0.207), dose reductions (P = 0.740), discontinuation due to adverse events (P = 0.175) or overall incidence of grade 3–4 toxicities (P = 0.112), more patients in the lymphopenia group had grade 3–4 neutropenia (P = 0.017), grade 3–4 thrombocytopenia (P = 0.017) and grade 3–4 diarrhea (P = 0.006). In multivariate analysis, performance status and Heng score were predictors of progression-free survival (P = 0.015 and P = 0.0006, respectively), while performance status, Heng score, and lymphopenia were found to be significantly associated with overall survival (P = 0.007, P < 0.0001 and P = 0.023, respectively).

Conclusions
Sunitinib appears to be safe and active in elderly patients with lymphopenia. Lymphocyte count is an independent prognostic factor for overall survival in elderly patients with mRCC treated with first-line sunitinib.

 

结论:
舒尼替尼对于发生淋巴细胞减少的老年患者安全、有效。淋巴细胞计数是老年转移性肾细胞癌患者接受舒尼替尼一线治疗总体生存预后的独立预测因子。

 

学科代码:肿瘤学 老年病学   关键词:接受舒尼替尼治疗的老年转移性肾细胞癌患者的淋巴细胞减少及临床 ,全球精选文摘 爱思唯尔医学网, Elseviermed
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