Effect of cytokine therapy on survival for patients with advanced renal cell carcinoma
Effect of cytokine therapy on survival for patients with advanced renal cell carcinoma
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DOI：
10.1200/jco.2000.18.9.1928
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发表时间：
2000-05-01
影响因子：
45.3
通讯作者：
Metz, EM
中科院分区：
文献类型：
--
作者：
Motzer, RJ;Mazumdar, M;Metz, EM
目的：评价细胞因子治疗与生存的关系，探讨肾切除术对生存的影响，并在670例晚期肾癌（RCC）患者队列中确定长期存活者。患者和方法：共670例晚期肾癌患者接受24项临床试验的全身化疗或细胞因子治疗作为回顾性分析的对象。396例（59%）患者接受细胞因子治疗（含干扰素和/或白细胞介素-2），274例（41%）患者接受化疗（细胞毒或激素治疗），在670例患者中，生存时间大于5年的患者被确定为长期幸存者。结果：无论治疗年份或基于预处理特征的风险类别，细胞因子治疗患者的生存时间都比化疗患者长。细胞因子治疗的有利、中等和低风险患者的中位生存时间分别为27、12和6个月，化疗患者的中位生存时间分别为15、7和3个月。中位生存期在有利风险组和中等风险组的差异更大。两种治疗方案的低风险组中位生存时间均小于6个月。在既往肾切除术患者中，中位生存时间为14个月，加上从诊断到治疗的时间大于1年，而从诊断到治疗的时间小于1年的患者中位生存时间为8个月，无论预处理肾切除术情况如何，670例患者中有30例（4.5%）被确定为长期幸存者；结论：晚期肾癌患者实现长期生存的比例较低，需要进行临床研究以寻找更有效的治疗方法。(C) 2000年由美国临床肿瘤学会出版。
Purpose: To evaluate the relationship between treatment with cytokine therapy and survival, investigate the effect of nephrectomy on survival, and identify long-term survivors among a cohort of 670 patients with advanced renal cell carcinoma (RCC),Patients and Methods: A total of 670 patients with advanced RCC treated on 24 clinical trials of systemic chemotherapy or cytokine therapy were the subjects of this retrospective analysis. treatment was categorized as cytokine (containing interferon alfa and/or interleukin-2) in 396 patients (59%) and as chemotherapy (cytotoxic or hormonal therapy) in 274 (41%), Among the 670 patients, those with survival times of greater than 5 years were identified as long-term survivors,Results: Patients heated with cytokine therapy had a longer survival time than did those heated with chemotherapy, regardless of the year of treatment or risk category based on pretreatment features. The median survival times for favorable-, intermediate-, and poor-risk patients were 27, 12, and 6 months for those treated with cytokines and 15, 7, and 3 months for those treated with chemotherapy, respectively. The magnitude of difference in median survival was greater in the favorable- and intermediate-risk groups. The median survival time was less than 6 months in the poor-risk group for both treatment programs. Median survival time was 14 months among patients with prior nephrectomy plus time from diagnosis to treatment greater than 1 year versus 8 months among those with time from diagnosis to treatment less than 1 year, regardless of pretreatment nephrectomy status, Thirty patients (4.5%) among the 670 patients were identified as long-term survivors; 12 were free of disease after nephrectomy and treatment with interferon alfa, interleukin-2 or surgical resection of metastasis,Conclusion: The low proportion of patients with advanced RCC who achieve long-term survival emphasizes the need for clinical investigation to identify more effective therapy. (C) 2000 by American Society of Clinical Oncology.