Combination Treatment of Interferon alpha-2a plus 13-cis Retinoic Acid and Radiation Therapy in Cervical Cancer / 대한부인종양콜포스코피학회잡지

ABSTRACT

Cervical cancer is one of the leading causes of cancer death worldwide. A major research in cervical cancer is focused on the development of new active agents arid agents to potentiate radiotherapy effect in locally advanced diseases. Both interferons and retinolds are known to possess antiproliferative, differentiate, and immunomodulatory properties, but they probably exert these effects through separate molecular mechanisms. The rationale for adding interferon and retinoid to standard radiotherapy is based on the independent major activity of combination of these biological agents and the additive and synergistic effects of these agents with radiation in mammalian cells in tissue culture. This study was undertaken to assess the clinical response and toxicity of the combination regimens of interferon alpha-2a(IFN alpha-2a), 13-cis-retinoic acid(13-cRA) with radiotherapy from Nov. 1994 to Nov. 1995 at Chungnam National University Hospital. Twenty seven patients with locally advanced cervical carcinoma enrolled in this study were evaluated. Thirteen of these patients who were previously untreated(study group) were treated with 13-cRA(1mg/kg) orally and recombinant human IFN alpha-2a(6 million units) subcutaneously daily for one week and then, on the second week, IFN alpha-2a was administered with the same dosage every other day and 13-cRA was administered 0.5mg /kg/oral for 8 weeks combined with the standard radiotherapy. Eleven of these patients(control group) who were previously untreated were treated only with standard radiotherapy Three patients who had recurrence after initial treatment were treated with IFN alpha-2a and 13-cRA with the same amount for 8 weeks. THE RESULS WERE AS FOLLOWS; 1. Preliminary result of the response rate of IFN alpha-2a, 13-cRA with radiotherapy was 92.3%(complete response 61.5%, partial response 30.8%) and that of radiotherapy only was 91.0%(complete response 45.5%,partial response 45.5%). 2. Reduced tumor volume was 95.64+/-80.03cm(3) in the study group and 25.28+/-35.82cm(3) in the control group. There was a significant difference in the reduced tumor volume between the study and the control group(p<0.05). 3. The major toxicity of IFN alpha-2a, 13-cRA with radiothrapy was cheilitis(92.3%), fever(84.5%), general myalgia(53.8%) and conjunctivitis(53.8%). 4. The treatment with IFN alpha-2a and 13-cRA in recurrent ceivical cancer showed no effect. As a result, these data suggest that systemic IFN alpha-2a, 13-cRA with radiotherapy is highly active and is a well tolerable therapy for locally advanced cervical cancer.