| 진행성 신세포암에서 Interferon-α, Interleukin-2, 5-fluorouracil을 이용한 면역화학요법의 치료효과 분석 |
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김한석, 성병주, 김두용, 김택상, 류현열 |
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고신대학교 의과대학 비뇨기과학교실 |
| Analysis of Efficacy of Immunochemotherapy of Interferon-α, Interleukin-2 and 5-fluorouracil in Advanced Renal Cell Carcinomas |
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Han Seok Kim , Byeong Ju Seong , Du Yong Kim , Taek Sang Kim , Hyun Yul Rhew |
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Department of Urology, Kosin University College of Medicine, Busan, Korea |
Correspondence:
Hyun Yul Rhew
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| Abstract |
Purpose
Despite numerous trials of various immunochemotherapeutic agents, advanced renal cell carcinomas (RCC) remain highly resistant to treatment. We evaluated the efficacy and toxicity, and the factors affecting to responses of a low-dose subcutaneous regimen of interferon-α(IFN-α) in combination with intravenous administration of 5-fluorouracil(5-FU) with interleukin-2(IL-2). Materials and Methods: From November 1999 to November 2005, 69 patients with advanced RCC were treated with an 8 week cycle of 6 to 9MU/m2 IFN-α given 1 to 3 times a week during the 8 week period, and sequentially combined with 5 to 20MU/m2 IL-2 given 3 times a week for 4weeks and 750mg/m2 5-FU once a week for 4 weeks. In this retrospective analysis, all patients were divided into locally advanced and metastatic disease groups, The nephrectomy status, cancer stage at the beginning of the immunotherapy, and metastasized organs were considered, and responses to treatment were evaluated accordingly in each group. Results: Among 50 consecutive men and 19 women treated, 47 had measurable metastatic lesion. Objective tumor regression was achieved in 16 patients, consisting of 2 complete remission and 14 partial response. Metastatic sites were lung in 9 patients, bone in 7 patients, Stable diseases lasting over 3 months were noted in 11 patients, other 20 patients out of 47 patients were considered to progressive disease. There were only mild to moderate side effects; maximum toxicity grade of 0 in 31 patients, grade 1 in 10, 2 in 22, 3 in 6 according to World Health Organization classification. None of the patients experienced major IL-2 related toxicity and no toxic deaths occurred. Conclusions: This combination immunochemotherapy may be a promising regimen with modest toxicity in advanced RCC. Most side effects were tolerable. Advanced RCC exhibited a very limited response, and nephrectomy status was revealed to be the only significant factor affecting survival. The efficacy of immunotherapy on locally advanced RCC needs further controlled evaluative studies.(Korean J Urol Oncol 2007;5:36-41) |
| Key Words:
Immunochemotheraphy, Renal cell carcinoma, Interferon-α, Interleukin-2 |
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