Khabele Dineo, Runowicz Carolyn D, Fields Abbie L, Anderson Patrick S, Goldberg Gary L
Department of Obstetrics & Gynecology and Women's Health, Division of Gynecologic Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA.
Gynecol Oncol. 2003 Jun;89(3):420-3. doi: 10.1016/s0090-8258(03)00080-5.
Intraperitoneal interferon-alpha (IP-IFNalpha) has shown some benefit in the treatment of patients with ovarian cancer. Our goal was to evaluate the use of low-dose IP-IFNalpha for the palliative control of ascites in non-ovarian gynecologic malignancies, including primary peritoneal and uterine papillary serous carcinomas.
Fifteen patients with non-ovarian gynecologic malignancies received one or two doses of 10 MU (10 x 10(6) U/m(2)) of IP-IFNalpha via single-use drum catheter for the symptomatic control of ascites. The median age for this patient group was 61 years (range 40-84). Histopathologic diagnoses were confirmed on all patients. Eleven of 15 (73%) patients had uterine cancers. Four of 15 (27%) patients had papillary serous primary peritoneal carcinomas. Thirteen of 15 (87%) patients had Stage III disease or more. All patients had been heavily pretreated with chemotherapy and all had progressive disease.
Specific parameters used to evaluate IP-IFNalpha were (1) median survival; (2) number of days to recurrent ascites; (3) number of subsequent paracenteses required for symptomatic relief; and (4) symptomatology and side effects. Median overall survival was 3 months (range 0.5-13). Seven of 15 (47%) patients survived >3 months. Twelve of 15 (80%) patients had recurrent ascites within 30 days of treatment. However, 3/15 (20%) patients had a prolonged, >30-day period, without symptomatic ascites. One patient (6%) had a 270-day response with no ascites. Toxicity was minimal from IP-IFNalpha infusion. The most common side effect was fever in 6/15 (40%) patients.
IP-IFNalpha was well tolerated and may have some benefit in a subset of patients. Although 80% of patients had recurrent ascites within 30 days, 20% had a prolonged, >30-day response. Further study is warranted to determine the role of immune modulators, such as IP-IFNalpha, in the palliative management of patients with non-ovarian gynecologic malignancies that cause ascites.
腹腔内注射α干扰素（IP-IFNα）已显示出对卵巢癌患者治疗有一定益处。我们的目标是评估低剂量IP-IFNα用于姑息控制非卵巢妇科恶性肿瘤（包括原发性腹膜癌和子宫乳头状浆液性癌）腹水的效果。
15例非卵巢妇科恶性肿瘤患者通过一次性鼓形导管接受一或两剂10 MU（10×10⁶U/m²）的IP-IFNα，用于对症控制腹水。该患者组的中位年龄为61岁（范围40 - 84岁）。所有患者的组织病理学诊断均得到证实。15例患者中有11例（73%）患有子宫癌。15例患者中有4例（27%）患有乳头状浆液性原发性腹膜癌。15例患者中有13例（87%）处于III期或更晚期。所有患者均接受过大量化疗且均为疾病进展期。
用于评估IP-IFNα的具体参数为：（1）中位生存期；（2）复发性腹水出现的天数；（3）为缓解症状所需的后续腹腔穿刺次数；（4）症状和副作用。总中位生存期为3个月（范围0.5 - 13个月）。15例患者中有7例（47%）存活超过3个月。15例患者中有12例（80%）在治疗后30天内出现复发性腹水。然而，15例患者中有3例（20%）腹水症状缓解期延长，超过30天。1例患者（6%）有270天无腹水反应。IP-IFNα输注的毒性极小。最常见的副作用是6/15（40%）患者出现发热。
IP-IFNα耐受性良好，可能对一部分患者有益。虽然80%的患者在30天内出现复发性腹水，但20%的患者有延长至超过30天的反应。有必要进一步研究以确定免疫调节剂如IP-IFNα在姑息治疗引起腹水的非卵巢妇科恶性肿瘤患者中的作用。
