Clinical value of individualized neoadjuvant chemotherapy for renal carcinoma to reduce adverse reaction under the guidance of gene detection / 中国综合临床

ABSTRACT

Objective To investigate the clinical significance of individualized neoadjuvant chemotherapy for renal carcinoma to reduce side effects under the guidance of gene detection.Methods From January 2011 to March 2014,two hundred and twelve patients with renal carcinoma treated in Cangzhou Central Hospital were enrolled in the study and randomly divided into the gene detection group (102 cases) and non-gene detection group (110 cases).The gene detection group was detected by the real time fluorescence quantitative (RT-PCR) method and the drug sensitivity test was carried out,and the patients were given neoadjuvant chemotherapy based on the results of drug sensitivity test.The patients in the non-gene detection group were treated with the national comprehensive cancer network (NCCN) experience regimen.The incidence of chemotherapy side effects was compared between the two groups.Results The 1 year survival rate of the gene test group was higher than that in the non-gene detection group (87.25％ (89/102) vs.77.27％ (85/ 110),x2 =4.67,P＜0.05),and the 3 year survival rate increased (70.58％ (72/102) vs.64.54％ (71/110),x2 =4.510,P＜ 0.05) as well,the differences were statistically significant (P ＜ 0.05).The incidence of liver injury in the gene detection group was 17.64％ (18/102),which was lower than that in the control group 30％ (33/110),the difference was statistically significant (x2 =4.42,P ＜ 0.05).In the gene detection group,the incidence of leukocyte 3～4 level inhibition was 27.5％ (28/102),which was higher than that in the non-gene detection group 21.8％ (24/110).The difference was statistically significant (x2 =4.940,P ＜ 0.05).Conclusion Genetic polymorphisms detection is a guide to the application of tumor sensitive drugs in the individualized neoadjuvant chemotherapy of renal carcinoma.It can improve the therapeutic effect,and also reduce the occurrence of liver injury caused by side effects of chemotherapy and has high clinical application value.