Randomised, controlled study of intratumoral recombinant gamma-interferon treatment in newly diagnosed glioblastoma.
Randomised, controlled study of intratumoral recombinant gamma-interferon treatment in newly diagnosed glioblastoma.
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DOI：
10.1038/bjc.1994.263
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发表时间：
1994-07
影响因子：
8.8
通讯作者：
Mantyla, M
中科院分区：
文献类型：
--
作者：
Farkkila, M;Jaaskelainen, J;Kallio, M;Blomstedt, G;Raininko, R;Virkkunen, P;Paetau, A;Sarelin, H;Mantyla, M
研究了新诊断的成人高级别脑胶质瘤瘤内注射重组干扰素γ（rIFN-γ）作为开放性细胞减灭术和60戈伊外照射的辅助治疗对生存率的影响。在手术过程中，患者被随机分为rIFN-γ组（n = 14）或对照组（n = 17），后者接受皮下注射rIFN-γ。肿瘤内给予rIFN-γ，每周三次，持续4周，直到放疗，剂量从5微克增加到50微克。两组均接受40戈伊的全脑外照射和20戈伊的局部加强照射。放疗后，rIFN-γ继续50微克，每周两次，长达9周。患者未接受化疗。肿瘤内rIFN-γ耐受良好，仅出现一过性发热。对照组有12例胶质母细胞瘤（GB），rIFN-γ组有9例完成照射。每三个月对患者进行一次临床随访和计算机断层扫描（CT），直至死亡。在三个干扰素治疗（一个仍然存活45个月后手术）和两个常规治疗的患者中观察到肿瘤反应。肿瘤体积在CT上的进展在IFN治疗组和对照组之间没有差异。存活时间无差异。rIFN-γ治疗患者的中位生存期为54周（95%CI 35-68），对照患者为55周（95%CI 41-77）。研究中给予的瘤内rIFN-γ剂量似乎不能抑制肿瘤生长或改善高级别胶质瘤患者的预后。
The effect of intratumoral recombinant interferon gamma (rIFN-gamma) as adjuvant to open cytoreduction and external irradiation of 60 Gy on survival in adults with a newly diagnosed high-grade cerebral glioma was studied. The patients were randomised during surgery into the rIFN-gamma group (n = 14) or the control group (n = 17), and the latter received a subcutaneous reservoir of rIFN-gamma injections. Intratumoral rIFN-gamma was given three times a week for 4 weeks until radiotherapy, escalating the dose from 5 micrograms to 50 micrograms. Both groups received external whole-brain irradiation of 40 Gy and a local boost of 20 Gy. After radiotherapy, rIFN-gamma was continued with 50 micrograms twice a week up to 9 weeks. The patients received no chemotherapy. Intratumoral rIFN-gamma was tolerated well with transient fever only. There were 12 glioblastomas (GBs) in the control group and nine in the rIFN-gamma group with completed irradiation. The patients were followed clinically and by computerised tomography (CT) every third month until death. Tumour responses were seen in three interferon-treated (one still alive 45 months after operation) and in two conventionally treated patients. The progression of the tumour volumes on CT did not differ between the IFN-treated and control groups. There were no differences in the survival times. Median survival of the rIFN-gamma-treated patients was 54 weeks (95% CI 35-68) and of the control patients 55 weeks (95% CI 41-77). Intratumoral rIFN-gamma given in the study doses does not seem to inhibit tumour growth or improve the prognosis of patients with high-grade glioma.