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

作　　者：金谷[1] 夏李明[1] 吴昊[1] 邹瀚辉 李涛[1] 

机构地区：[1]浙江省肿瘤医院,浙江杭州310022

出　　处：《肿瘤学杂志》2017年第11期950-954,共5页Journal of Chinese Oncology

基　　金：浙江省医药卫生科技计划项目资助(2012KYA032)

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AJCCⅡB～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/m^2,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,N_3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。[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.

关 键 词：干扰素 恶性黑色素瘤 剂量限制性毒性 耐受性 

分 类 号：R739.5[医药卫生—肿瘤]