Thiounn N
Clinique Urologie, Hôpital Cochin, Paris.
J Urol (Paris). 1994;100(5):231-7.
Nearly 2,500 new cases of metastatic renal cell carcinoma are diagnosed in France every year. Only immunotherapy has demonstrated some therapeutic responses, owing to antitumoral activity of T lymphocytes, CDS and also CD4. This review illustrates results from different therapeutic regimen with interferon alpha, interleukin-2 (intravenous or subcutaneous), alone or in association, and adoptive immunotherapy with in vitro activated lymphocytes. Response rates ranged from 15 to 30%, with a 10% complete response rate. High level of serum interleukin-6 and C-reactive protein predicted unfavorable evolution and lack of response to immunotherapy. Improvement in the response rate needs the selection of patients who are potentially responder and new therapeutic association, especially interleukin-2, interferon alpha and 5-fluoro-uracil.
法国每年有近2500例转移性肾细胞癌新发病例。由于T淋巴细胞、CD8和CD4的抗肿瘤活性,只有免疫疗法显示出了一些治疗反应。本综述阐述了使用α干扰素、白细胞介素-2(静脉注射或皮下注射)单独或联合使用的不同治疗方案,以及采用体外激活淋巴细胞的过继免疫疗法的结果。缓解率在15%至30%之间,完全缓解率为10%。血清白细胞介素-6和C反应蛋白水平高预示着病情进展不利且对免疫疗法无反应。要提高缓解率,需要挑选可能有反应的患者并采用新的联合治疗方法,尤其是白细胞介素-2、α干扰素和5-氟尿嘧啶联合使用。