替西罗莫司联合索拉非尼治疗晚期肾癌的效果及对患者血清基质金属蛋白酶-9与金属蛋白酶组织抑制剂-1水平的影响

目的探讨替西罗莫司联合索拉非尼治疗晚期肾癌的效果及对患者血清基质金属蛋白酶-9(MMP-9)、金属蛋白酶组织抑制剂-1(TIMP-1)水平的影响。方法选取2011年3月至2016年6月惠东县人民医院收治的晚期肾癌患者72例作为研究对象,按照入院先后顺序编号,应用随机信封法将所有患者分为对照组与观察组,各36例。对照组患者给予索拉非尼,观察组在对照组治疗基础上辅以替西罗莫司治疗。比较两组患者生命质量、临床疗效、血清MMP-9和TIMP-1水平、不良反应及生存期。结果治疗后,两组患者生命质量各维度评分明显提高,且观察组患者生命质量各维度评分明显高于对照组(P<0.05);观察组患者治疗有效率为30.56%,明显高于对照组11.11%(χ^2=4.126,P=0.042);观察组患者疾病控制率为83.33%,显著高于对照组(χ^2=4.431,P=0.035);治疗后,两组患者血清MMP-9和TIMP-1水平明显降低,且观察组患者血清MMP-9和TIMP-1水平显著低于对照组(P<0.05);治疗期间,两组患者皮疹、腹泻、手足皮肤反应、食欲不振、脱发、恶心呕吐、耳鸣及发热发生率比较,差异无统计学意义(P>0.05);观察组患者3年生存率为41.67%,明显高于对照组的19.44%(χ^2=4.189,P=0.041)。结论替西罗莫司联合索拉非尼治疗晚期肾癌,可有效提高临床疗效,改善患者生命质量,下调血清MMP-9和TIMP-1水平,延长患者生存期,安全性好。

Effects of Temsirolimus Combined with Sorafenib in the Treatment of Advanced Renal Cell Carcinoma and Its Influence on Serum Mmp-9 And Timp-1 of Patients

Objective To explore the effects of Temsirolimus combined with Sorafenib in the treatment of advanced renal cell carcinoma and its effects on serum MMP-9 and TIMP-1.Methods A total of 72 cases of patients with advanced renal cell carcinoma,who were treated in urology department of Huidong County People’s Hospital from June 2011 to June 2016 were selected as the study subjects and they were divided into a control group and a observation group according to the order of admission,random envelope method applied.The control group was treated with Sorafenib,and the observation group was treated with Temsirolimus supplemented by Sorafenib.Quality of life,clinical efficacy,serum levels of MMP-9 and TIMP-1,adverse reactions and overall survival time were compared.Results After treatment,the scores of quality life for each dimension in the 2 groups were significantly improved,and scores of quality life for each dimension in the observation group were significantly higher than those in the control group(P<0.05).The clinical effective rate in the observation group was 30.56%,which was significantly higher than that in the control group(11.11%)(χ^2=4.126,P=0.042),and the disease control rate in the observation group was 83.33%,which was significantly higher than that in the control group(χ^2=4.431,P=0.035).The levels of serum MMP-9 and TIMP-1 in the 2 groups were significantly lower and the levels of serum MMP-9 and TIMP-1 in the observation group were significantly lower than those in the control group(P<0.05).During the treatment period,there was no significant difference between the 2 groups in the incidences of rash,diarrhea,skin reaction to hands and feet,loss of appetite,hair loss,nausea and vomiting,tinnitus and fever in the 2 groups(P>0.05).The 3-year survival rate of patients in the observation group was 41.67%,which was significantly higher than that in the control group(19.44%)(χ^2=4.189,P=0.041).Conclusion Temsirolimus combined with Sorafenib in the treatment of advanced renal cell carcinoma can effectively improve the clinical efficacy,enhance the quality of life of patients,down-regulate the levels of serum MMP-9 and TIMP-1,and prolong the survival time of patients,with high safety.