α干扰素用于复发性世界卫生组织1级颅内脑膜瘤

Interferon-alpha for recurrent World Health Organization grade 1 intracranial meningiomas.

作者信息

Chamberlain Marc C, Glantz Michael J

机构信息

Department of Neurology, University of Washington/Fred Hutchinson Cancer Research Center, Seattle, Washington 98109-1023, USA.

出版信息

Cancer. 2008 Oct 15;113(8):2146-51. doi: 10.1002/cncr.23803.

DOI:10.1002/cncr.23803

PMID:18756531

Abstract

BACKGROUND

Intracranial meningiomas are common, they frequently recur after surgery or radiotherapy, and there are limited data regarding the treatment of intracranial meningiomas with chemotherapy. A phase 2 study was designed to estimate the 6-month progression-free survival of patients with recurrent, treatment-refractory, World Health Organization grade 1 meningiomas who were treated with interferon-alpha.

METHODS

Thirty-five patients with recurrent meningiomas ranging in age from 36 years to 88 years (median age, 61 years) were treated according to a prospective phase 2 study. All patients had received prior surgery, radiotherapy, (involved-field radiotherapy in 35 patients andstereotactic radiotherapy in 22 patients), and chemotherapy (hydroxyurea in 19 patients and other in 17 patients). On radiographic documentation of progressive disease, interferon-alpha (at a dose of 10 million U/m(2) administered subcutaneously every other day) was initiated. A complete blood count and chemistry panel was obtained before every cycle, and cranial magnetic resonance images were obtained every 3 months.

RESULTS

The most common grade 3 and 4 toxicities were fatigue (6 patients; 17%), anemia (3 patients; 8.6%), and leukopenia (3 patients; 8.6%) (toxicities were graded according to the National Cancer Institute's Common Toxicity Criteria [version 3.0]). Three patients went off study because of toxicity, and 7 patients required a dose reduction. There were no treatment-related deaths or delays in therapy reported. All patients were assessable for response. No patient demonstrated a neuroradiographic complete or partial response. Twenty-six patients demonstrated stable disease after the first 3 cycles of interferon-alpha, and 9 patients had progressive disease. The progression-free survival rate was 54% at 6 months and 31% at 12 months. The median time to tumor progression was 7 months (range, 2-24 months). The median survival was 8 months (range, 3-28 months).

CONCLUSIONS

Treatment with interferon-alpha for recurrent meningiomas was found to be tolerated moderately well and was modestly effective.

摘要

背景

颅内脑膜瘤很常见，术后或放疗后常复发，而关于化疗治疗颅内脑膜瘤的数据有限。一项2期研究旨在评估接受α干扰素治疗的复发性、治疗难治性世界卫生组织1级脑膜瘤患者的6个月无进展生存率。

方法

根据一项前瞻性2期研究，对35例年龄在36岁至88岁（中位年龄61岁）的复发性脑膜瘤患者进行治疗。所有患者均曾接受过手术、放疗（35例接受累及野放疗，22例接受立体定向放疗）和化疗（19例接受羟基脲治疗，17例接受其他化疗）。在影像学记录疾病进展后，开始使用α干扰素（剂量为1000万U/m²，隔日皮下注射）。每个周期前进行全血细胞计数和生化检查，每3个月进行头颅磁共振成像检查。

结果

最常见的3级和4级毒性反应为疲劳（6例患者；17%）、贫血（3例患者；8.6%）和白细胞减少（3例患者；8.6%）（毒性反应根据美国国立癌症研究所通用毒性标准[第3.0版]分级）。3例患者因毒性反应退出研究，7例患者需要减量。未报告与治疗相关的死亡或治疗延迟。所有患者均可评估疗效。没有患者出现神经影像学完全或部分缓解。26例患者在接受α干扰素的前3个周期后病情稳定，9例患者病情进展。6个月时无进展生存率为54%，12个月时为31%。肿瘤进展的中位时间为7个月（范围为2至24个月）。中位生存期为8个月（范围为3至28个月）。