Négrier S, Mercatello A, Coronel B, Lanier F, Merrouche Y, Bret M, Blay J Y, Lasset C, Thiesse P, Carrie C
Département de médecine carcinologique, Centre Léon-Bérard, Lyon, France.
Bull Cancer. 1993 Jul;80(7):601-9.
Between October 1987 and June 1992, 244 patients with metastatic renal carcinoma were referred to our Institute. One hundred and sixty-nine were included in immunotherapy protocols. The 40 most recent patients were included in the ongoing multicentric randomised Crecy study. The previous patients were treated with IL2 as a continuous infusion or high doses intravenous IL2 combined with alpha interferon (IFN) or a combination of IL2 and IFN as subcutaneous low doses. Some patients received as rescue treatment a combination of IL2 with Tumor Necrosis Factor (TNF). First line immunotherapy with cytokines gave 14-25% response rates in these patients with 5-10% of complete persistent remissions. The most intensive regimen was responsible for the most severe toxicity as well as the highest response rate. TNF does not appear to be of great concern since its systemic administration induced important limiting toxicities. This work emphasizes the need for prospective studies in order to evaluate the optimal mode and schedule of treatment as well as to investigate the impact of immunotherapy on survival.
1987年10月至1992年6月期间，244例转移性肾癌患者被转诊至我院。其中169例纳入免疫治疗方案。最近的40例患者纳入正在进行的多中心随机Crecy研究。之前的患者接受白细胞介素-2（IL2）持续输注治疗，或大剂量静脉注射IL2联合α干扰素（IFN），或皮下小剂量IL2与IFN联合治疗。部分患者接受IL2与肿瘤坏死因子（TNF）联合的挽救治疗。这些患者接受细胞因子一线免疫治疗的缓解率为14%-25%，完全持续缓解率为5%-10%。最强化的治疗方案导致最严重的毒性反应，但缓解率也最高。由于全身给药会引起严重的毒性反应，TNF似乎不是主要的治疗选择。这项研究强调了开展前瞻性研究的必要性，以便评估最佳的治疗方式和方案，并研究免疫治疗对生存的影响。
