Di Bartolomeo M, Bajetta E, Zilembo N, de Braud F, Di Leo A, Verusio C, D'Aprile M, Scanni A, Barduagni M, Barduagni A [corrected to Barduagni M ]
Division of Medical Oncology B, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy.
Acta Oncol. 1993;32(2):235-8. doi: 10.3109/02841869309083918.
The prognosis and the quality of life of patients with carcinoid tumors is related either to symptoms from the substances secreted or to progressive tumor growth. Medical treatment with cytotoxic agents is of marginal value for increasing life expectancy and reducing clinical symptoms. Recent studies with interferon have shown interesting results. In the present investigation, 22 patients with carcinoid tumors and syndrome were treated with recombinant interferon alpha-2a (r-IFN alpha-2a) at the dose of 6 x 10(6) IU intramuscularly daily for 8 weeks and three times weekly thereafter. The primary tumor was localized in the foregut (n = 11), midgut (n = 7), hindgut (n = 1), and unknown site (n = 3). Most cases had liver metastasis. Seventeen patients had elevated 5-hydroxyindoloacetic acid (5-HIAA) excretion and 5 had flushing and/or diarrhea as the only clinical manifestation. Six cases presented a complete syndrome (flushing, diarrhea and 5-HIAA excretion). Control of symptoms was obtained in 80% and a 5-HIAA level reduction in 58% of the patients. The interferon treatment was more effective for control of the carcinoid syndrome than for control of tumor growth. The treatment was well tolerated and fever, myalgia, anorexia and fatigue were the most frequent side-effects.
类癌患者的预后和生活质量与所分泌物质引起的症状或肿瘤的进行性生长有关。使用细胞毒性药物进行医学治疗在延长预期寿命和减轻临床症状方面价值有限。最近关于干扰素的研究显示出了有趣的结果。在本研究中，22例患有类癌和类癌综合征的患者接受了重组干扰素α-2a（r-IFNα-2a）治疗，剂量为每日6×10⁶国际单位，肌肉注射8周，之后每周三次。原发性肿瘤位于前肠（n = 11）、中肠（n = 7）、后肠（n = 1）以及部位不明（n = 3）。大多数病例有肝转移。17例患者5-羟吲哚乙酸（5-HIAA）排泄升高，5例仅有潮红和/或腹泻作为唯一临床表现。6例呈现完整的综合征（潮红、腹泻和5-HIAA排泄）。80%的患者症状得到控制，58%的患者5-HIAA水平降低。干扰素治疗在控制类癌综合征方面比控制肿瘤生长更有效。该治疗耐受性良好，发热、肌痛、厌食和疲劳是最常见的副作用。
