Benasso M, Merlano M, Blengio F, Cavallari M, Rosso R, Toma S
Department of Medical Oncology I, Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy.
Am J Clin Oncol. 1993 Dec;16(6):465-8. doi: 10.1097/00000421-199312000-00001.
The combination of chemotherapy and interferons has been tested in several human tumors but, until now, no clinical data have been reported in head and neck cancer. At the Istituto Nazionale per la Ricerca sul Cancro of Genoa, 14 patients with previously treated SCC-HN underwent the following regimen: cisplatin, 20 mg/m2/day, 5-fluorouracil, 200 mg/m2/day i.v. bolus and recombinant interferon-alpha-2b (r-IFN-alpha-2b) (Intron-A, Shering-Plough), 3 MIU/day i.m., for 5 consecutive days. Recombinant IFN-alpha-2b was also administered, at the same dosage, 3 times per week during the 2 weeks interval among cycles. Grade III-IV hematological toxicity was recorded in 43% of patients. Increasing fatigue, anorexia, and flu-like symptoms were experienced by most patients. For these reasons 9 of 14 patients needed a chemotherapy delay and a r-IFN-alpha-2b discontinuation. Therefore, due to the heavy toxicity observed, accural was terminated early. The overall response rate was 54% (31% CR, 23% PR). Among the 5 patients who never delayed chemotherapy and discontinued r-IFN-alpha-2b, all but one responded. In conclusion, a synergistic activity between chemotherapy and r-IFN-alpha-2b in head and neck cancer cannot be excluded, but, in our opinion, further investigations should consider less aggressive regimens and/or more selected patients.
化疗与干扰素联合应用已在多种人类肿瘤中进行了试验，但迄今为止，头颈部癌尚无临床数据报道。在热那亚国立癌症研究所，14例既往接受过治疗的头颈部鳞状细胞癌患者接受了以下治疗方案：顺铂，20mg/m²/天，5-氟尿嘧啶，200mg/m²/天静脉推注，以及重组干扰素-α-2b（r-IFN-α-2b）（Intron-A，先灵葆雅公司），3MIU/天肌肉注射，连续5天。在各周期之间的2周间隔期内，重组干扰素-α-2b也以相同剂量每周给药3次。43%的患者出现了III-IV级血液学毒性。大多数患者出现了疲劳、厌食和流感样症状加重。由于这些原因，14例患者中有9例需要推迟化疗并停用r-IFN-α-2b。因此，鉴于观察到的严重毒性，提前终止了入组。总体缓解率为54%（完全缓解率31%，部分缓解率23%）。在5例从未推迟化疗且未停用r-IFN-α-2b的患者中，除1例之外均有反应。总之，不能排除化疗与r-IFN-α-2b在头颈部癌中有协同活性，但我们认为，进一步的研究应考虑采用侵袭性较小的治疗方案和/或选择更合适的患者。
