Lygidakis N J, Spenzouris N, Dedemadi G, Kyriakou A, Theodorakopoulos M
Clinic of Surgical Oncology, Athens Medical Center (Dept of P. Faliron), Greece.
Hepatogastroenterology. 1998 Mar-Apr;45(20):404-10.
BACKGROUND/AIMS: The clinical application of intrasplenic immunostimulation with IL-2 in a group of patients suffering from metastatic renal carcinoma, melanoma, recurrent rectal carcinoma, lung carcinoma and gastric carcinoma are discussed in terms of clinical applicability, effectiveness and survival.
From May 1996 to February 1998, 45 patients with advanced malignancies were admitted to Athens Medical Center for intrasplenic immunostimulation. Transplenic immunostimulation was carried out via a subcutaneously implanted port. The injected therapy included IL-2 (Proleukin) 1 ml 18 x 10(6) suspended in 1.5 ml of lipiodol and 0.5 ml of urografin. In conjunction gamma-INF (Immukin) 0.5 ml 100 mcg, was administered.
Patients included in this study have completed their treatment, or are still undergoing maintenance treatment. The duration of the CR was between 11 and 16 months, and for PR was between 10-14 months. For melanoma patients (n = 9), 3 patients with PD died 9, 10 and 12 months after initial treatment began. The remaining patients (n = 6) are alive with a mean survival rate of 16 months. Of those patients, 4 have been classified as complete responders, being completely free of disease at this time. The number of CR for patients with lung, renal and recurrent rectal cancer was achieved as a result of the continuing maintenance treatment. Twenty-two patients remain alive and 23 patients have died. From those alive (n = 22), 10 patients are complete responders and free of disease, 10 are partial responders with controlled disease and 2 remain with standard disease. For those surviving patients with lung cancer, the mean survival time is 14 months. Patients with recurrent rectal cancer and renal cancer were shown to have a mean survival time of 15 and 13 months, respectively.
The safety, effectiveness and feasibility of long-lasting administration of high dosages of IL-2 are documented from the data of this study. Intrasplenic immunostimulation utilizing lipiodol-urografin emulsion as a carrier, offers new possibilities for the safe administration of long lasting high dosages of IL-2 and gamma-INF. Further studies are warranted, to further elucidate the results of this phenomenon.
背景/目的：探讨白细胞介素-2（IL-2）脾内免疫刺激在一组转移性肾癌、黑色素瘤、复发性直肠癌、肺癌和胃癌患者中的临床应用，包括临床适用性、有效性和生存率。
1996年5月至1998年2月，45例晚期恶性肿瘤患者入住雅典医疗中心接受脾内免疫刺激治疗。经皮下植入端口进行经脾免疫刺激。注射治疗包括将1ml含18×10⁶单位的IL-2（普罗力金）悬浮于1.5ml碘油和0.5ml泛影葡胺中。同时给予0.5ml含100μg的γ-干扰素（免疫金）。
本研究中的患者已完成治疗或仍在接受维持治疗。完全缓解（CR）持续时间为11至16个月，部分缓解（PR）持续时间为10至14个月。对于黑色素瘤患者（n = 9），3例疾病进展（PD）患者在初始治疗开始后9、10和12个月死亡。其余患者（n = 6）存活，平均生存率为16个月。其中，4例被归类为完全缓解者，目前完全无疾病。肺癌、肾癌和复发性直肠癌患者的CR是持续维持治疗的结果。22例患者存活，23例患者死亡。在存活的患者（n = 22）中，10例为完全缓解者且无疾病，10例为部分缓解者且疾病得到控制，2例仍有标准疾病。对于存活的肺癌患者，平均生存时间为14个月。复发性直肠癌和肾癌患者的平均生存时间分别为15个月和13个月。
本研究数据证明了高剂量IL-2长期给药的安全性、有效性和可行性。以碘油-泛影葡胺乳剂为载体的脾内免疫刺激为安全给予长期高剂量的IL-2和γ-干扰素提供了新的可能性。有必要进行进一步研究以进一步阐明这一现象的结果。
