金 谷,夏李明,吴 昊.恶性黑色素瘤大剂量干扰素辅助治疗诱导期的耐受性观察[J].肿瘤学杂志,2017,23(11):950-954.
恶性黑色素瘤大剂量干扰素辅助治疗诱导期的耐受性观察
Tolerability of Patients with Maliguant Melanoma to Induction Phase of Adjuvant High-dose Interferon Therapy
投稿时间:2017-01-15  
DOI:10.11735/j.issn.1671-170X.2017.11.B003
中文关键词:  干扰素  恶性黑色素瘤  剂量限制性毒性  耐受性
英文关键词:interferon  malignant melanoma  dose-limiting toxicity  tolerability
基金项目:
作者单位
金 谷 浙江省肿瘤医院 
夏李明 浙江省肿瘤医院 
吴 昊 浙江省肿瘤医院 
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中文摘要:
      摘 要:[目的] 观察恶性黑色素瘤患者术后大剂量干扰素辅助治疗诱导期的耐受性。[方法] 回顾性分析2011年6月至2015年6月我院收治的203例AJCC ⅡB~Ⅲ期恶性黑色素瘤患者并接受术后大剂量α-2b干扰素辅助治疗,其中4周静脉诱导期剂量为1500万IU/m2,采用NCI-CTCAE 4.0评定诱导期药物相关不良事件,观察剂量限制性毒性相关事件和治疗中进展情况。[结果] 全部203例患者诱导期均接受药物相关不良事件评价,共发生剂量限制性毒性34例次,主要为4级粒细胞减少(8.4%)和3级肝酶升高(4.4%)。21例患者遵循减量计划完成诱导,7例患者未完成诱导期治疗,原因包括3例进展,2例明显疲乏,1例重度肝功能不全和1例3级斑丘疹。1年大剂量干扰素治疗中共有42例进展,N3组复发转移率达50%。[结论] 大剂量干扰素在中国人群中有较好的耐受性,但对于3个以上淋巴结转移的相对更高危患者,干扰素似乎有效率不高。
英文摘要:
      Abstract:[Objective] To observe the tolerability of patients with malignant melanoma to induction phase of adjuvant high-dose interferon therapy. [Methods] We retrospectively analyzed 203 cases of AJCC ⅡB~Ⅲ malignant melanoma received high-dose interferon alfa-2b in our hospital from June 2011 to June 2015. In 4 week intravenous induction phase,patients received IFN-alfa-2b at the dose of 15×106IU/m2(5 days per week) and drug-related adverse events were evaluated by NCI-CTCAE 4.0. The dose-limiting toxicity events and the progression of disease were observed. [Results] All 203 patients were evaluated for drug-related adverse events in the induction phase,with a total of 34 cases of dose-limiting toxicity,mainly grade 4 neutropenia (8.4%) and grade 3 liver enzyme elevation (4.4%). Twenty-one patients followed the reduction schedule and 7 patients discontinued the therapy in the induction phase,including 3 progression,2 with significant fatigue,1 with severe hepatic insufficiency,and 1 with grade 3 maculopapular rash. There were 42 cases developed disease progression during the high-dose interferon therapy and the progression rate in the N3 group was 50%. [Conclusion] High dose interferon alfa-2b can be well tolerated by Chinese patients,but interferon appears to be inefficient in patients with relatively higher risk of more than three lymph node metastases.
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