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皮下注射白细胞介素-2受体(IL-2r)和干扰素α-2b(IFN Alfa-2b)治疗转移性肾细胞癌的临床经验

[Clinical experience with the treatment of metastatic renal cell carcinoma with subcutaneous interleukin-2r (IL-2r) and interferon Alpha-2b (IFN Alfa-2b)].

作者信息

Olivier C, Carballido J, Lao A H, Gimeno A, Martín C, Renjifo D, Ondina L M, Manzano L, Alvarez-Mon M

机构信息

Servicio de Urología, Clínica Puerta de Hierro, Madrid.

出版信息

Actas Urol Esp. 1995 Jan;19(1):16-26.

PMID:7717154
Abstract

This work presents our recent clinic experience in the treatment of advanced RCC with IL-2 in association to alpha IFN given subcutaneously. Fifteen patient with histologically confirmed advanced RCC and measurable lesions were entered in the study. Patients were treated in cycles of 7 weeks at a IL-2 dose of 4.8 million IU/m2 (induction phase)-2.4 million IU/m2 (maintenance phase) every 12h five days a week and alpha IFN: 6 million IU/m2 every 24h three days a week, and were afterwards evaluated for response. Responders with localized residual bulk underwent rescue surgery. Seven patient has objective response (3 complete, 2 partial and 2 stable responses). The complete responses were stable and lasted 36 m, 14 m and 8 m, and global survival was of 14.6 m (3-36 m). All patients had toxicity at various degrees but WHO grade II was not exceeded at any time. The association of IL-2 and alpha IFN 2b given subcutaneously, appears to have antitumoral activity against advanced RCC with durable responses and in a proportion similar to other associations in intravenous administration, but with lower systemic toxicity. Surgical resection of residual bulk can be beneficial in selected patient with partial response.

摘要

这项工作展示了我们近期使用皮下注射白细胞介素-2联合α干扰素治疗晚期肾细胞癌的临床经验。15例经组织学确诊为晚期肾细胞癌且有可测量病灶的患者进入该研究。患者接受为期7周的治疗周期,白细胞介素-2剂量为480万IU/m²(诱导期)-240万IU/m²(维持期),每周五天,每12小时一次,α干扰素:600万IU/m²,每周三天,每24小时一次,之后评估反应情况。有局部残留肿块的反应者接受挽救性手术。7例患者有客观反应(3例完全缓解,2例部分缓解,2例病情稳定)。完全缓解情况稳定,持续36个月、14个月和8个月,总生存期为14.6个月(3-36个月)。所有患者均有不同程度的毒性反应,但任何时候均未超过世界卫生组织二级。皮下注射白细胞介素-2和α干扰素2b联合使用,似乎对晚期肾细胞癌具有抗肿瘤活性,反应持久,比例与其他静脉给药联合方案相似,但全身毒性较低。对部分缓解的特定患者进行残留肿块的手术切除可能有益。

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