INTERFERON INSTILLATION FOR MALIGNANT PLEURAL EFFUSIONS
INTERFERON INSTILLATION FOR MALIGNANT PLEURAL EFFUSIONS
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DOI：
10.1093/oxfordjournals.annonc.a058416
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发表时间：
1993-02-01
影响因子：
50.5
通讯作者：
MAKSYMIUK, AW
中科院分区：
文献类型：
--
作者：
GOLDMAN, CA;SKINNIDER, LF;MAKSYMIUK, AW
背景：恶性胸腔积液的治疗方法多种多样，包括胸腔灌注化疗药物。α-干扰素-2b（IFN-alpha 2b）的注入已成功用于各种局部恶性肿瘤，表明其在胸腔积液管理中可能发挥作用。本试验的目的是评估的耐受性和疗效的胸腔内IFN-α 2b intraluminulations在这种situation.Patients和方法：23例细胞学证实的恶性胸腔积液给予IFN-α 2b 50 × 10（6）单位在50毫升生理盐水（NS）胸腔内滴注后，部分或完全清除积液经皮抽吸或胸管引流。对于持续性或复发性积液，重复滴注，剂量递增至75 × 10（6）单位。患者进行了评估和定期的临床检查，胸片，生化和血液学参数和淋巴细胞亚群的测定，直到复发或death in each case.Results：14的20例（70%）可评估的患者反应持续中位时间为6个月，有8个完全反应（CR）和6个部分反应（PR）。在6例CR患者中，首次滴注后积液未复发。在其他6例患者中，2例第二次滴注成功诱导CR。胸腔内滴注IFN-α 2b耐受性良好，未发生4级毒性。在初始剂量水平下，对任何研究参数均无显著影响;然而，随着剂量递增，发生了3级中性粒细胞减少症。最常见的毒性是流感样综合征，后70%的inflations.Conclusions：IFN-α 2b胸膜内滴注产生了令人鼓舞的反应率没有显着的毒性。这种方法可能需要额外的II期或III期比较临床研究。
Background: Malignant pleural effusions can be managed in various ways including instillation of antineoplastic agents. Instillations of alfa interferon-2b (IFN-alpha2b) have been utilized with success in various loco-regional malignancies suggesting a possible role in management of pleural effusions. This trial was designed to evaluate the tolerability and efficacy of intrapleural IFN-alpha2b instillations in this situation.Patients and methods: Twenty-three patients with cytologically proven malignant pleural effusions were given IFN-alpha2b 50 x 10(6) units in 50 ml normal saline (NS) by intrapleural instillation after partial or complete clearance of effusions by percutaneous aspiration or chest tube drainage. For persistent or recurrent effusions, instillations were repeated with dose escalation to 75 x 10(6) Units. Patients were assessed and monitored by regular clinical examinations, chest radiographs, biochemical and hematological parameters and assays of lymphocyte subpopulations until relapse or death in each case.Results: Fourteen of 20 evaluable patients (70%) had responses lasting for a median of 6 months; there were 8 complete responses (CR) and 6 partial responses (PR). In 6 CR patients the effusions did not recur after the first instillation. In 2 of 6 other patients, the second instillation was successful in inducing CR. Intrapleural instillation of IFN-alpha2b was well tolerated, no grade 4 toxicities were encountered. There were no significant effects on any of the studied parameters at the initial dose level; however, grade 3 neutropenia occurred with the escalated dose. The most common toxicity was flu-like syndrome, after 70% of the instillations.Conclusions: Intrapleural instillation of IFN-alpha2b produced an encouraging response rate without significant toxicities. This approach may warrant additional phase II or phase III comparative clinical studies.