腹腔内放射免疫治疗卵巢癌的长期预后预测因素。
Predictors of long-term outcome from intraperitoneal radioimmunotherapy for ovarian cancer.
机构信息
Departments of Radiation Oncology, Medicine, Pathology and Gynecology, University of Alabama Comprehensive Cancer Center, Birmingham, Alabama, USA.
出版信息
Cancer Biother Radiopharm. 2012 Feb;27(1):36-40. doi: 10.1089/cbr.2011.1111. Epub 2012 Jan 12.
Data was analyzed from 92 patients > 5 years after intraperitoneal (IP) radionuclide therapy (RIT) with (90)Y- or (177)Lu-CC49 to determine prognostic factors. Patients had CC49 antibody-reactive ovarian cancer confined to the abdominal cavity after primary debulking and chemotherapy. The first 27 patients received IP (177)Lu-CC49 alone; the remainder received Interferon (IFN), to increase the expression of the tumor-associated glycoprotein-72 (TAG-72) antigen, +/- IP paclitaxel (25-100 mg/m(2)) 2 days before RIT. Factors assessed by univariate (and some multivariate) analysis included age, race, body size, interval between initial diagnosis and RIT, interval between 2nd look surgery and RIT, (90)Y versus (177)Lu, MBq dose, paclitaxel dose, grade of tumor, extent of initial surgery, size of disease deposits prior to RIT, intensity of TAG reactivity, the addition of unlabeled antibody, and the development of human anti-mouse antibody and/or serum sickness after murine antibody. A statistically significant improvement in progression-free survival (p ≤ 0.05) was noted for less bulky disease and younger age. Administration of paclitaxel plus IFN, an immune response, and use of (90)Y showed a favorable nonsignificant trend. Dose escalation of radionuclide did not change risk of progression; thus, this therapy may have therapeutic efficacy at modest dose levels.
对 92 例接受腹腔内(IP)放射性核素治疗(RIT)的患者进行数据分析,这些患者在初次减瘤和化疗后,体内的(90)Y-或(177)Lu-CC49 仅局限于腹腔内,且体内存在针对 CC49 抗体的卵巢癌。前 27 例患者单独接受 IP(177)Lu-CC49 治疗;其余患者接受干扰素(IFN)治疗,以增加肿瘤相关糖蛋白-72(TAG-72)抗原的表达,在 RIT 前 2 天,+/-腹腔紫杉醇(25-100mg/m2)。通过单因素(和一些多因素)分析评估的因素包括年龄、种族、体型、初始诊断与 RIT 之间的间隔、第二次手术与 RIT 之间的间隔、(90)Y 与(177)Lu、MBq 剂量、紫杉醇剂量、肿瘤分级、初始手术范围、RIT 前疾病沉积物的大小、TAG 反应强度、未标记抗体的添加、以及在鼠抗体后人类抗鼠抗体和/或血清病的发展。与体积较大的疾病和较年轻的年龄相比,无进展生存期(progression-free survival,PFS)有显著改善(P ≤ 0.05)。紫杉醇联合 IFN 给药、免疫反应以及(90)Y 的使用显示出有利的非显著趋势。放射性核素的剂量递增并没有改变进展的风险;因此,这种疗法在适度剂量水平可能具有治疗效果。