Smalley R V, Andersen J W, Hawkins M J, Bhide V, O'Connell M J, Oken M M, Borden E C
University of Wisconsin Clinical Cancer Center, Madison.
N Engl J Med. 1992 Nov 5;327(19):1336-41. doi: 10.1056/NEJM199211053271902.
Interferon alfa has been found to be effective as an antitumor agent (with a response rate of 30 percent) in patients with low-grade non-Hodgkin's lymphoma, but its effectiveness in those with intermediate-grade non-Hodgkin's lymphoma has been less adequately tested. In a prospective randomized study we evaluated the effectiveness of adding interferon alfa to cytotoxic chemotherapy in patients with clinically aggressive, low-grade non-Hodgkin's lymphoma and certain histologic variants of intermediate-grade non-Hodgkin's lymphoma, not including diffuse histiocytic lymphoma.
The patients were randomly assigned to a regimen of cyclophosphamide, vincristine, prednisone, and doxorubicin or to this regimen combined with recombinant interferon alfa. Treatment was administered every four weeks, for 8 to 10 cycles.
The two regimens produced comparable objective responses, but the regimen including interferon had a greater effect in prolonging the time to treatment failure (P < 0.001) and the duration of complete response (P = 0.03). Interferon alfa also had a greater effect on overall survival (P = 0.014) when the results were adjusted for important covariates.
Interferon alfa, when added to a four-drug doxorubicin-based chemotherapy regimen, is an effective antitumor agent in patients with clinically aggressive low-grade or intermediate-grade non-Hodgkin's lymphoma.
已发现干扰素α作为抗肿瘤药物对低度非霍奇金淋巴瘤患者有效（缓解率为30%），但其对中度非霍奇金淋巴瘤患者的有效性尚未得到充分测试。在一项前瞻性随机研究中，我们评估了在细胞毒性化疗基础上加用干扰素α对临床侵袭性低度非霍奇金淋巴瘤及某些中度非霍奇金淋巴瘤组织学亚型（不包括弥漫性组织细胞淋巴瘤）患者的有效性。
患者被随机分配接受环磷酰胺、长春新碱、泼尼松和阿霉素方案治疗，或该方案联合重组干扰素α治疗。每四周进行一次治疗，共8至10个周期。
两种方案产生了相当的客观缓解率，但含干扰素的方案在延长治疗失败时间（P<0.001）和完全缓解持续时间（P = 0.03）方面效果更佳。在对重要协变量进行校正后，干扰素α对总生存期也有更大影响（P = 0.014）。
对于临床侵袭性低度或中度非霍奇金淋巴瘤患者，在基于阿霉素的四联化疗方案中加用干扰素α是一种有效的抗肿瘤药物。
