Primary metastatic osteosarcoma: results of a prospective study in children given chemotherapy and interleukin-2
Primary metastatic osteosarcoma: results of a prospective study in children given chemotherapy and interleukin-2
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DOI：
10.1007/s12032-017-1052-9
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发表时间：
2017-11-01
期刊：
影响因子：
3.4
通讯作者：
Luksch, Roberto
中科院分区：
文献类型：
--
作者：
Meazza, Cristina;Cefalo, Graziella;Luksch, Roberto
为了改善儿童转移性骨肉瘤（OS）的不良预后，在标准治疗中加入白细胞介素-2（IL-2），因为其能够激活淋巴细胞并将淋巴细胞亚群分化为能够识别和杀死各种肿瘤细胞的淋巴因子激活的杀伤（LAK）细胞。这项研究涉及一组年龄< 18岁的转移性OS患者，他们在1995年至2010年期间接受了IL-2、大剂量甲氨蝶呤、多柔比星、顺铂、异环磷酰胺、LAK回输和手术治疗。35例患者，年龄4-17岁。35例患者中有32例接受了原发肿瘤手术，25例接受了肺转移瘤手术。27例患者接受IL-2 + LAK回输。中位随访时间为130个月（77-228），3年无事件生存率和总生存率分别为34.3%和45.0%。11例患者仍然存活，所有患者均实现了原发性肿瘤和肺转移的完全手术切除（1例患者由于肺转移完全缓解而未接受肺切除术）。原发灶和转移灶手术完全缓解且化疗反应良好的患者无事件生存率更高。这些结果证实了手术完全缓解的重要性，并指出我们系列患者的显著（尽管仍在改善）生存率，这是IL-2和LAK/NK细胞活化免疫治疗的潜在作用。
To improve the poor prognosis for children with metastatic osteosarcoma (OS), interleukin-2 (IL-2) was added to the standard treatment due to its capacity to activate lymphocytes and differentiate lymphocyte subsets into lymphokine-activated killer (LAK) cells that are capable of recognizing and killing various tumor cells. This study concerns a cohort of unselected patients aged < 18 years with metastatic OS, who were treated with IL-2, high-dose methotrexate, doxorubicin, cisplatin, ifosfamide, LAK reinfusion, and surgery, between 1995 and 2010. Thirty-five patients aged 4-17 years were involved. Thirty-two of the 35 patients underwent surgery on their primary tumor, and 25 had surgery on lung metastases too. Twenty-seven patients received IL-2 plus LAK reinfusion. The median follow-up was 130 months (77-228), and the 3-year event-free and overall survival rates were 34.3 and 45.0%, respectively. Eleven patients remained alive, all of whom achieved a complete surgical removal of the primary tumor and lung metastases (1 patient did not receive lung resections due to complete lung metastases remission). Patients who had a complete surgical remission of the primary and metastatic sites and who responded well to chemotherapy had a better event-free survival. These results confirm the importance of complete surgical remission and point to a noteworthy (though still be ameliorate) survival rate in our series of patients, underling a potential role for immunotherapy with IL-2 and LAK/NK cell activation.