Toxicity of combined treatment of adjuvant irradiation and interferon a2b in high-risk melanoma patients
Toxicity of combined treatment of adjuvant irradiation and interferon a2b in high-risk melanoma patients
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DOI：
10.1097/cmr.0b013e3282c3a6ed
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发表时间：
2007-10-01
影响因子：
2.2
通讯作者：
Castel, Teresa
中科院分区：
文献类型：
--
作者：
Conill, Carlos;Jorcano, Sandra;Castel, Teresa
手术切除的III期黑色素瘤患者通常接受干扰素（IFN）2 α B的辅助治疗。对于那些具有引流淋巴结复发高危特征的患者，放射治疗也可以被视为一种治疗选择。这项回顾性研究的目的是评估这种联合治疗的疗效和放射相关毒性。回顾性分析了18例在放射治疗期间或完成后1个月内接受IFN α 2b辅助治疗的患者的结局。18名患者中有16名接受了600 cGy/次的放射治疗，每周2次，2名患者接受了200 cGy/次的放射治疗，每周5次。放疗总剂量和分割次数分别为30戈伊/5次（n = 8）、36戈伊/6次（n = 8）和50戈伊/25次（n=2）。3年时无疾病患者（无局部复发）的百分比为88%。在10名患者中，IFNa 2b与放疗同时施用;在3名患者中，在放疗前或放疗后30天内施用;在5名患者中，在放疗后30天以上施用。所有患者均发生急性皮肤反应，放射治疗肿瘤学组（RTOG）评分为I级。在一名患者中观察到晚期辐射相关毒性，其中一名患者出现III级（RTOG）皮肤反应，两名患者出现IV级（RTOG）辐射诱导的肌萎缩。同时使用辅助放疗和干扰素α 2b可能会增强辐射诱导的毒性，当脊髓被纳入辐射区时应特别小心。
Surgically resected stage III melanoma patients commonly receive adjuvant therapy with interferon (IFN) 2 alpha b. For those patients with high-risk features of draining node recurrence, radiation therapy can also be considered as a treatment option. The purpose of this retrospective study was to assess the efficacy and radiation -related toxicity of this combined therapy. Eighteen patients receiving adjuvant IFN alpha 2b therapy during radiation therapy, or within 1 month of its completion, were reviewed retrospectively and analysed for outcome. Radiation was delivered at 600cGy dose per fraction, in 16 out of 18 patients, twice a week, and at 200 cGy dose per fraction in two patients five times a week. Total radiation dose and number of fractions were as follows: 30 Gy/5 fir (n = 8), 36 Gy/6 f r (n = 8) and 50 Gy/25fr (n=2). The percentage of disease-free patients, with no local recurrence, at 3 years was 88%. In 10 patients, IFNa2b was administered concurrently with radiotherapy; in three, within 30 days before or after radiation; and in five, more than 30 days after radiation. All the patients experienced acute skin reactions, grade I on the Radiation Therapy Oncology Group (RTOG) scale. Late radiation-related toxicity was seen in one patient with grade III (RTOG) skin reaction and two with grade IV (RTOG) radiation-induced myelitis. Concurrent use of adjuvant radiotherapy and IFN alpha 2b might enhance radiation-induced toxicity, and special care should be taken when the spinal cord is included in the radiation field.