Esteban-González Emilio, Carballido Joaquín, Navas Víctor, Torregrosa Zoila, Muñoz Antonio, de Mon Melchor Alvarez
Oncology Department, Central Hospital, Oviedo, Spain.
Anticancer Drugs. 2007 Mar;18(3):291-6. doi: 10.1097/CAD.0b013e328011a4fc.
Pulmonary metastases of renal cell carcinoma are associated with poor prognosis. Systemic interleukin-2 is used to treat pulmonary metastases of renal cell carcinoma; however, its toxicity limits its use. The objective of this study was to evaluate the efficacy and safety of inhaled interleukin-2 in pulmonary metastases of renal cell carcinoma patients. The study was designed as a retrospective chart review in pulmonary metastases of renal cell carcinoma patients treated with inhaled interleukin-2. Between 2000 and 2004, 19 centres in Spain and two in Portugal recruited 51 patients. The treatment schedule was as follows: three cycles of 36 MIU interleukin-2 per day for 5 days/week for 12 weeks (with 1 treatment-free week between cycles) in Spain and for 3 weeks (out of each 4 weeks) for 12 weeks in Portugal. Efficacy was assessed by best response following each treatment cycle and at final evaluation. Kaplan-Meier method was used to estimate progression-free survival and overall survival. Safety data were analysed using descriptive statistics, with toxicities expressed in number of weeks, which were reported. Overall objective response rate was 13.7% (95% confidence interval: 5.7-26.3). Median progression-free survival and overall survival were 8.6 (95% confidence interval: 3.45-16.5) and 23 (95% confidence interval: 11.5-34.5) months. The most common toxicities were cough (40% of cycles) and fatigue (7%). The majority of weeks of toxicities were reported to be only grade 1 or 2 in severity. Inhaled interleukin-2 shows efficacy and mild toxicity of pulmonary metastases of renal cell carcinoma patients, and might be considered as an alternative treatment to the systemic administration of this drug in these patients.
肾细胞癌肺转移与预后不良相关。全身性白细胞介素-2用于治疗肾细胞癌肺转移;然而,其毒性限制了其应用。本研究的目的是评估吸入性白细胞介素-2治疗肾细胞癌肺转移患者的疗效和安全性。该研究设计为对接受吸入性白细胞介素-2治疗的肾细胞癌肺转移患者进行回顾性病历审查。2000年至2004年期间,西班牙的19个中心和葡萄牙的2个中心招募了51名患者。治疗方案如下:在西班牙,每天36 MIU白细胞介素-2,每周5天,共3个周期,持续12周(周期之间有1周无治疗期);在葡萄牙,每4周中有3周,每天36 MIU白细胞介素-2,每周5天,共12周。在每个治疗周期后及最终评估时,通过最佳反应评估疗效。采用Kaplan-Meier法估计无进展生存期和总生存期。使用描述性统计分析安全性数据,毒性以报告的周数表示。总体客观缓解率为13.7%(95%置信区间:5.7 - 26.3)。中位无进展生存期和总生存期分别为8.6个月(95%置信区间:3.45 - 16.5)和23个月(95%置信区间:11.5 - 34.5)。最常见的毒性反应是咳嗽(40%的周期)和疲劳(7%)。大多数毒性反应周数报告为仅1级或2级严重程度。吸入性白细胞介素-2对肾细胞癌肺转移患者显示出疗效且毒性轻微,可被视为这些患者全身性应用该药物的替代治疗方法。