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自然干扰素 α 作为 II 期或 III 期肾细胞癌辅助治疗的随机对照研究。

Randomized controlled study of natural interferon α as adjuvant treatment for stage II or III renal cell carcinoma.

机构信息

Department of Pharmacoepidemiology, Kyoto University, Kyoto, Japan.

出版信息

Int J Clin Oncol. 2013 Feb;18(1):68-74. doi: 10.1007/s10147-011-0345-9. Epub 2011 Nov 9.

Abstract

BACKGROUND

The prophylactic effect of postoperative interferon on recurrence and distant metastasis in stage II or III renal cell carcinoma is unclear. In most studies, interferon has been administered for 6 months or less. Therefore, we performed a clinical study of the efficacy of 1-year postoperative administration of natural interferon α, which is generally used in Japan.

METHODS

The subjects were patients diagnosed with stage II or III renal cell carcinoma who underwent radical nephrectomy. The subjects were randomly allocated to receive an intramuscular injection of natural interferon α (3 million to 6 million units) 3 times a week for 1 year or to receive follow-up observation until recurrence or metastasis occurred. Chest and abdominal CT were performed once yearly for all patients. The primary endpoint was progression-free survival.

RESULTS

From September 2001 to August 2006, a total of 107 patients were registered, but 7 subsequently withdrew from the study. Therefore, 100 patients were included in the analysis. The primary endpoint of progression-free survival did not differ significantly between the groups that received natural interferon α or follow-up observation (p = 0.456, log-rank test). However, peak hazards of progression in the interferon group were delayed for about 6-10 months compared with the observation group.

CONCLUSION

Progression-free survival showed no improvement after administration of natural interferon α to patients with stage II or III renal cell carcinoma for 1 year after radical nephrectomy. The peak hazards of progression might be delayed by about 6 months by interferon administration.

摘要

背景

术后干扰素对 II 期或 III 期肾细胞癌的复发和远处转移的预防作用尚不清楚。在大多数研究中,干扰素的使用时间都在 6 个月以内。因此,我们进行了一项关于术后使用日本常规应用的天然干扰素 α 进行 1 年治疗的疗效的临床研究。

方法

研究对象为接受根治性肾切除术的 II 期或 III 期肾细胞癌患者。将患者随机分为两组,一组接受肌内注射天然干扰素 α(300 万至 600 万单位),每周 3 次,共 1 年;另一组接受随访观察,直至复发或转移。所有患者每年进行 1 次胸部和腹部 CT 检查。主要终点为无进展生存期。

结果

2001 年 9 月至 2006 年 8 月,共有 107 例患者登记,但其中 7 例随后退出研究。因此,共有 100 例患者纳入分析。接受天然干扰素 α或随访观察的两组之间,无进展生存期的主要终点无显著差异(p = 0.456,对数秩检验)。然而,干扰素组的进展高峰危险度比观察组延迟了约 6-10 个月。

结论

根治性肾切除术后,对 II 期或 III 期肾细胞癌患者使用天然干扰素 α 1 年,无进展生存期无改善。干扰素治疗可使进展的高峰危险度延迟约 6 个月。

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