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Systematic Review Article

靶向疗法如何影响肾细胞癌的肾外科手术

卷 21, 期 15, 2020

页: [1550 - 1557] 页: 8

弟呕挨: 10.2174/1389450121666200704150933

价格: $65

摘要

在2005年底至2006年初之间，已经引入了几种新的靶向疗法来治疗肾细胞癌。在这篇综述中，我们旨在探讨和总结在肾细胞癌患者中使用全身治疗的主要发现及其对手术的影响。我们确定了三种不同的设置：新辅助和辅助设置，以及转移性肾细胞癌患者的全身治疗与手术的关联。酪氨酸激酶抑制剂的新辅助靶标治疗可促进肿瘤切除并降低总体肿瘤直径及其复杂性。但是，大多数证据来自小型的I或II期临床试验，结果往往相矛盾，而未确定所研究的主要参数（例如肿瘤的复杂性）是否发生相关变化。在辅助治疗中，关键性试验的结果表明，对于通过手术治疗的非转移性RCC患者使用酪氨酸激酶抑制剂是不利的。确实，大多数来自单项临床试验的证据和荟萃分析的汇总结果未能发现使用辅助性全身治疗的生存优势。迄今为止，全身靶向治疗后临床疗效的改善只能在细胞减灭性肾切除术中发现。但是，最近的CARMENA和SURTIME试验证实了mRCC和预后不良的患者反对手术治疗的证据。在不久的将来，通过使用免疫疗法可能会带来重大变化。

关键词: 肾肿瘤，全身疗法，免疫疗法，肾脏手术，mRCC，CARMENA和SURTIME。

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