Современная онкология (Dec 2015)
Comparative evaluation of the efficacy of an incomplete cytoreduction application in combination with systemic therapy and systemic therapy as mono-therapy in patients with metastatic clear-cell renal cell carcinomas
Abstract
The introduction of targeted therapy drugs into the practice of oncology urologists has improved the results of treatment of patients with metastatic clear-cell renal cell carcinomas (mCCRCC). Correctly chosen elements of systemic therapy will help specialist to control the course of the metastatic process for more than 2 years. But, sooner or later, the refractoriness will be developed at each stage of systemic treatment therefore it is important to find the existing methods accompanied the systemic therapy. These methods should increase and prolong the targeted drugs action or delay the time before the first targeted drugs prescription. Complex approach in the treatment of metastatic solid tumors is actively used in cancer therapy every day. Cytoreductive nephrectomy and complete cytoreduction(ectomy for metastasis) are widely used in the world practice, demonstrating the improvement of survival rates, while the necessary of incomplete cytoreductive surgical intervention application (iCSI) is a controversial problem in oncological community. However, the success of complex approach in the treatment of metastatic tumors in other locations gives reason to try this method once again in mCCRCC therapy.The aim is to compare the efficacy of complex approach consisted of targeted therapy and iCSI application in comparison with the targeted therapy as mono-therapy in the treatment of metastatic RCC (mRCC). Conclusions: the choice of combined treatment in patients with mCCRCC is proved. Survival rates in the group using combined treatment comparable to control group show the justification of this treatment method application. The study shows the potential efficacy of complex approach application as a therapy in mCCRCC patients. iCSI can also be used as independent treatment method in specific group of patients. This can help to increase the observation period in case of mCCRCC patients of 9 months.The efficacy of targeted therapy drugs application significantly higher in comparison with the immunotherapy usage in more than 2 times (17 and 13 months versus 6 months).
