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新辅助顺铂和干扰素α-2B在阴茎癌治疗及器官保留中的应用

Neoadjuvant cisplatin and interferon-alpha 2B in the treatment and organ preservation of penile carcinoma.

作者信息

Mitropoulos D, Dimopoulos M A, Kiroudi-Voulgari A, Zervas A, Dimopoulos C, Logothetis C J

机构信息

Department of Urology, Laiko General Hospital, Athens Medical School, Greece.

出版信息

J Urol. 1994 Oct;152(4):1124-6. doi: 10.1016/s0022-5347(17)32520-x.

Abstract

We investigated the antitumor activity and toxicity of cisplatin and interferon-alpha 2B as the primary treatment of penile carcinoma. A total of 13 consecutive patients with nonmetastatic, histologically confirmed invasive squamous cell carcinoma of the penis underwent treatment consisting of 20 mg./m.2 cisplatin intravenously and 5 x 10(6) mu./m.2 interferon-alpha 2B subcutaneously daily for 5 consecutive days. An equivalent dose of interferon was then administered subcutaneously every 2 days for 3 weeks and the regimen was repeated at 28-day intervals. Of 12 evaluable patients 9 responded: 4 achieved a pathologically confirmed complete remission of 38+, 21+, 10 and 7 months in duration (2 with relapse were treated with local therapy and remain with no evidence of disease), and 5 achieved a partial response, underwent surgical removal of residual disease and remained disease-free for 14+ to 24+ months. The most significant toxicities were anemia in 5 patients and reversible renal impairment in 3 but no patient had neutropenic fever or required platelet transfusion. We conclude that primary treatment with cisplatin and interferon-alpha 2B induced responses in 75% of 12 patients with penile carcinoma and allowed for a less radical operation than originally scheduled. A larger number of patients and longer followup will be required to confirm these encouraging preliminary results.

摘要

我们研究了顺铂和α-2B干扰素作为阴茎癌主要治疗方法的抗肿瘤活性及毒性。共有13例经组织学确诊的非转移性阴茎浸润性鳞状细胞癌患者连续接受了治疗,治疗方案为静脉注射20mg/m²顺铂,同时每日皮下注射5×10⁶单位/m²α-2B干扰素,连续5天。之后每2天皮下注射等量干扰素,共3周,该疗程每28天重复一次。12例可评估患者中,9例有反应:4例达到病理证实的完全缓解,缓解持续时间分别为38+、21+、10和7个月(其中2例复发后接受局部治疗,目前无疾病证据),5例达到部分缓解,接受了残留病灶的手术切除,无病生存14+至24+个月。最显著的毒性反应是5例患者出现贫血,3例出现可逆性肾功能损害,但无患者发生中性粒细胞减少性发热或需要输注血小板。我们得出结论,顺铂和α-2B干扰素的主要治疗使12例阴茎癌患者中的75%产生了反应,并且使得手术比原计划的根治性更小。需要更多患者及更长时间的随访来证实这些令人鼓舞的初步结果。

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