Eficacia y seguridad de sunitinib en el manejo del cáncer renal metastásico según sobrevida global
Fecha
2021
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Introducción: Aproximadamente un tercio de los pacientes con cáncer de células renales
(CCR) son diagnosticados cuando se encuentran cursando una etapa avanzada de la
enfermedad, esto influye en la expectativa de vida disminuyendo la tasa de supervivencia
global a 5 años a un 12 % si la enfermedad se acompaña de metástasis a distancia.
Objetivo: Describir la eficacia y seguridad de Sunitinib en la sobrevida global de los
pacientes atendidos en el Hospital Teodoro Maldonado Carbo.
Metodología: Estudio observacional, tipo descriptivo, correlacional, de corte transversal;
la población de estudio son todos pacientes que acudieron a consulta la Unidad Técnica
de Oncología desde 01 julio 2015 al 30 junio 2020 con diagnóstico de cáncer renal
metastásico (CCRm) que recibieron terapia con sunitinib.
Resultados La mediana de edad fue de 60 años (rango 49-70). El antecedente de
nefrectomía previa se identificó en el 80.36%, histológicamente predominó el carcinoma
de células claras (99.18%). A través del nomograma IMDC se identificó que el factor
pronóstico más común fue el tiempo desde el diagnóstico hasta el inicio de tratamiento
con sunitinib (menor 1 año) en el 60.36%. La puntuación de riesgo según IMDC para
CCRm estratificó a la población de estudio en los grupos de riesgo favorable 42.86%
grupo de riesgo intermedio 24.11% y riesgo pobre el 33.04%. La mortalidad para el grupo
de pronóstico pobre fue de 94.6%, del intermedio 74.1% a diferencia del favorable con
un 29.2% de pacientes que fallecieron. La sobrevida media estimada fue de 40, 12,5 y 6
meses para los grupos pronóstico favorable, intermedio y pobre respectivamente. El
38,3% de los pacientes en etapa metastásica que recibieron tratamiento con sunitinib
siguen con vida.
Conclusiones: El grupo de riesgo favorable tuvo mayor beneficio en sobrevida en
comparación con los otros subgrupos de riesgo por IMDC. La principal toxicidad
hematológica grave fue la neutropenia en 14.3%. Las toxicidades gastrointestinales más
frecuentes fueron mucositis y diarrea en un 3,6%
Introduction: Approximately a third of patients with kidney cancer are diagnosed when they are in an advanced stage of the disease, this influences life expectancy, reducing the overall 5-year survival rate by 12% if the disease is accompanied by distant metastasis. Objective: To describe the efficacy and safety of Sunitinib in the overall survival of patients treated at the Teodoro Maldonado Carbo Hospital. Methodology: Observational, descriptive, correlational, cross-sectional study; The study population is all patients who attended the Technical Oncology Unit from July 1, 2015 to June 30, 2020 with a diagnosis of metastatic kidney cancer (mCRC) who received therapy with sunitinib. Results: The median age was 60 years (range 49-70). A history of previous nephrectomy was identified in 80.36%, histologically clear cell carcinoma predominated (99.18%). Through the IMDC nomogram it was identified that the most common prognostic factor was the time from diagnosis to the start of treatment with sunitinib (less than 1 year) in 60.36%. The risk score according to IMDC for mCRC stratified the study population into the favorable risk groups 42.86%, intermediate risk group 24.11% and poor risk 33.04%. Mortality for the group with poor prognosis was 94.6%, of the intermediate 74.1% as opposed to the favorable one with 29.2% of patients who died. The estimated mean survival was 40, 12.5, and 6 months for the favorable, intermediate, and poor prognostic groups, respectively. The 38.3% of the metastatic patients who received treatment with sunitinib are still alive. Conclusions: The favorable risk group had a greater benefit in survival compared to the other risk subgroups due to IMDC. The main serious haematological toxicity was neutropenia in 14.3%. The most frequent gastrointestinal toxicities were mucositis and diarrhea in 3.6%.
Introduction: Approximately a third of patients with kidney cancer are diagnosed when they are in an advanced stage of the disease, this influences life expectancy, reducing the overall 5-year survival rate by 12% if the disease is accompanied by distant metastasis. Objective: To describe the efficacy and safety of Sunitinib in the overall survival of patients treated at the Teodoro Maldonado Carbo Hospital. Methodology: Observational, descriptive, correlational, cross-sectional study; The study population is all patients who attended the Technical Oncology Unit from July 1, 2015 to June 30, 2020 with a diagnosis of metastatic kidney cancer (mCRC) who received therapy with sunitinib. Results: The median age was 60 years (range 49-70). A history of previous nephrectomy was identified in 80.36%, histologically clear cell carcinoma predominated (99.18%). Through the IMDC nomogram it was identified that the most common prognostic factor was the time from diagnosis to the start of treatment with sunitinib (less than 1 year) in 60.36%. The risk score according to IMDC for mCRC stratified the study population into the favorable risk groups 42.86%, intermediate risk group 24.11% and poor risk 33.04%. Mortality for the group with poor prognosis was 94.6%, of the intermediate 74.1% as opposed to the favorable one with 29.2% of patients who died. The estimated mean survival was 40, 12.5, and 6 months for the favorable, intermediate, and poor prognostic groups, respectively. The 38.3% of the metastatic patients who received treatment with sunitinib are still alive. Conclusions: The favorable risk group had a greater benefit in survival compared to the other risk subgroups due to IMDC. The main serious haematological toxicity was neutropenia in 14.3%. The most frequent gastrointestinal toxicities were mucositis and diarrhea in 3.6%.
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Neoplasias renales, Metástasis de la neoplasia, Sunitinib, Epidemiología descriptiva, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador