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复发性恶性神经胶质瘤中β-干扰素的瘤内给药。一项I期临床和实验室研究。

Intratumor administration of beta-interferon in recurrent malignant gliomas. A phase I clinical and laboratory study.

作者信息

Fetell M R, Housepian E M, Oster M W, Cote D N, Sisti M B, Marcus S G, Fisher P B

机构信息

Department of Neurology, Columbia University, College of Physicians and Surgeons, New York, New York.

出版信息

Cancer. 1990 Jan 1;65(1):78-83. doi: 10.1002/1097-0142(19900101)65:1<78::aid-cncr2820650117>3.0.co;2-5.

Abstract

We administered doses of 5 to 180 x 10(6) IU of beta-serine-interferon (IFN-beta ser17) twice weekly to 20 patients with recurrent malignant gliomas in a Phase I study. Interferon was given through an Ommaya reservoir connected by a catheter to the tumor cavity. Side effects of interferon therapy occurred in only one patient and consisted of nausea, vomiting, fever, and chills after each treatment, presumably due to rapid diffusion of interferon into ventricular cerebrospinal fluid (CSF). Problems with the Ommaya reservoir (obstruction in two patients and infection in four patients) led to six patients being terminated from the study, and represent the major difficulty with this form of therapy. Although this was primarily a study of interferon toxicity, of 12 evaluable patients, 3 had stable disease for 148, 192, and 539 days; 9 had progressive disease. In addition, we tested the effect of IFN-beta ser17 on the growth of early passage in vitro cultures of malignant gliomas established from patients. Growth inhibition varied from 0% to more than 50%. In all cultures evaluated, the combination of recombinant gamma-interferon plus IFN-beta ser17 enhanced growth inhibition. Further clinical and laboratory study is necessary to better define the therapeutic efficacy of IFN-beta ser17 and the role of combinations of interferons in the treatment of malignant gliomas.

摘要

在一项I期研究中,我们每周两次给20例复发性恶性胶质瘤患者使用5至180×10⁶国际单位的β-丝氨酸干扰素(IFN-β ser17)。干扰素通过与肿瘤腔相连的奥马亚贮器经导管给药。仅1例患者出现了干扰素治疗的副作用,每次治疗后表现为恶心、呕吐、发热和寒战,推测是由于干扰素快速扩散至脑室脑脊液(CSF)所致。奥马亚贮器出现的问题(2例阻塞和4例感染)导致6例患者退出研究,这是这种治疗方式的主要困难所在。尽管这主要是一项关于干扰素毒性的研究,但在12例可评估的患者中,3例病情稳定达148天、192天和539天;9例病情进展。此外,我们检测了IFN-β ser17对从患者建立的恶性胶质瘤早期传代体外培养物生长的影响。生长抑制率从0%到超过50%不等。在所有评估的培养物中,重组γ-干扰素加IFN-β ser17的联合用药增强了生长抑制作用。需要进一步的临床和实验室研究来更好地确定IFN-β ser17的治疗效果以及干扰素联合用药在恶性胶质瘤治疗中的作用。

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