静脉联合应用低剂量IL-2和中等剂量IFN_(α-2b)治疗肾透明细胞癌的初步探讨

Intravenous infusion low-dose interleukin-2 and middle-dose interferon-2b for the treatment of patients with renal cell carcinoma

目的:探讨经静脉应用低剂量IL-2联合中等剂量的IFNα-2b在肾透明细胞癌中的应用价值及安全性。方法:IFNα-2b小剂量递增至1000万U/m2·d～2000万U/m2·d,静脉滴注7～10d,随后IFNα-2b300万U～600万U/m2,皮下注射,每周2次;静滴IFNα-2b期间IL-260～100万U/d,分次静脉推注或滴注,连续5天;以上每1月为一疗程。结果:3例肿瘤完全切除术后应用者生存4月、53月和65月迄今无复发转移;余7例带瘤生存2年以上1例,3年以上5例,5年以上1例,其中完全缓解2例,死亡1例(生存26月);副作用主要有发热、肌肉关节酸痛、食欲减退、轻度WBC下降等。结论:静脉联合应用低剂量IL-2和中等剂量IFNα-2b治疗肾透明细胞癌有效、安全,值得临床进一步研究。

Objective To evaluate the efficacy and safety of a regimen of low-dose interleukin-2(IL-2) plus middle-dose interferonα-2b(IFNα-2b) in the treatment for patients with renal cell carcinoma(RCC). Methods Ten patients of RCC, aged 26 to 71 years ,were treated with two to fifteen cycles of IFNα-2b administered by intravenous drip at a dose of 10×106 μ/m2·d for 7-10 days then followed by subcutaneous injection at a dose of 5×106 μto 10 ×106 twice weekly plus IL-2 was given by intravenous drip or bolus 5 times a day at a dose of 1×106 μ/d for 5 days per month. Results Of the 10 patients with RCC, 3 without measurable metastatic disease,2 achieved complete responses, 1 died at 26 months following operation , others survival with carcinoma for 29, 35,40,58 months. Toxicity of this combined regimen was mild, including fever, anorexia, muscle fatigue, anorexia, etc. Conclusions In view of the effective antitumor activity and reversible non-life-threatening side effects, this study suggest that combination of low-dose IL-2 and middle-dose IFNα-2b in the treatment of patients with renal cell carcinoma is worthwhile further studying.