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干扰素-α预防原发性肿瘤药物消融治疗后肝细胞癌复发的前瞻性随机对照研究。

Prospective randomized controlled study of interferon-alpha in preventing hepatocellular carcinoma recurrence after medical ablation therapy for primary tumors.

作者信息

Lin Shi-Ming, Lin Chun-Jung, Hsu Chao-Wei, Tai Dar-In, Sheen I-Shyan, Lin Deng-Yn, Liaw Yun-Fan

机构信息

Liver Research Unit, Chang Gung Memorial Hospitaland Chang Gung University, 199 Tung-Hwa North Road, Taipei, Taiwan.

出版信息

Cancer. 2004 Jan 15;100(2):376-82. doi: 10.1002/cncr.20004.

Abstract

BACKGROUND

Hepatocellular carcinoma (HCC) recurrence after ablation therapy for primary tumors is common.

METHODS

To evaluate the effectiveness of interferon-alpha (IFN-alpha) in preventing HCC recurrence, 30 eligible patients were randomized into three groups: 11 patients treated with three mega units (MU) of IFN-alpha three times weekly for 24 months (IFN-alpha-continuous group), 9 patients treated with 3 MU of IFN-alpha daily for 10 days every month for 6 months followed by 3 MU of IFN-alpha daily for 10 days every 3 months for a further 18 months (IFN-alpha-intermittent group), and 10 patients who received no IFN-alpha therapy (control group). The three groups were comparable in terms of etiology, demographics, and laboratory data at entry and HCC characteristics.

RESULTS

After a median follow-up of 27 months (range 4-53 months), 9 patients (90%) in the control group and 9 patients (45%) in 2 treatment groups (6 patients in the IFN-alpha-continuous group and 3 patients in the IFN-alpha-intermittent group) developed an HCC recurrence (P = 0.021). Cumulative HCC recurrence rates in the IFN-alpha-intermittent, IFN-alpha-continuous, and control groups were 22.2%, 27.3%, and 40% at the end of 1 year and 33.3%, 54.6%, and 90% at the end of 4 years (P = 0.0375), respectively (control vs. IFN-alpha-intermittent group, P = 0.0123; vs. IFN-alpha-continuous group, P = 0.0822). If both IFN-alpha groups were combined, the cumulative HCC recurrence rate of the patients treated with IFN-alpha and the control group was 25% and 40% at the end of 1 year and 47% and 90% at the end of 4 years, respectively (P = 0.0135).

CONCLUSIONS

The data suggested that IFN-alpha therapy may reduce HCC recurrence after medical ablation therapy for primary tumors.

摘要

背景

原发性肿瘤消融治疗后肝细胞癌(HCC)复发很常见。

方法

为评估α-干扰素(IFN-α)预防HCC复发的有效性,将30例符合条件的患者随机分为三组:11例患者接受3百万单位(MU)的IFN-α每周三次,共24个月(IFN-α连续治疗组);9例患者每月接受3 MU的IFN-α每日一次,共10天,持续6个月,随后每3个月接受3 MU的IFN-α每日一次,共10天,持续18个月(IFN-α间歇治疗组);10例患者未接受IFN-α治疗(对照组)。三组在入组时的病因、人口统计学和实验室数据以及HCC特征方面具有可比性。

结果

中位随访27个月(范围4 - 53个月)后,对照组9例患者(90%)以及2个治疗组中的9例患者(IFN-α连续治疗组6例,IFN-α间歇治疗组3例)(45%)发生了HCC复发(P = 0.021)。IFN-α间歇治疗组、IFN-α连续治疗组和对照组在1年末的累积HCC复发率分别为22.2%、27.3%和40%,在4年末分别为33.3%、54.6%和90%(P = 0.0375)(对照组与IFN-α间歇治疗组比较,P = 0.0123;与IFN-α连续治疗组比较,P = 0.0822)。如果将两个IFN-α组合并,接受IFN-α治疗的患者与对照组在1年末的累积HCC复发率分别为25%和40%,在4年末分别为47%和90%(P = 0.0135)。

结论

数据表明,IFN-α治疗可能会降低原发性肿瘤药物消融治疗后的HCC复发率。

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