Clinical study on the preventive effect of high-dose immuno-chemotherapy on the recurrence and metastasis of renal cell carcinoma / 中华泌尿外科杂志

ABSTRACT

Objective To study the preventive effect of high-dose immuno-chemotherapy on the recurrence and metastasis of renal cell carcinoma(RCC). Methods Overall 18 patients with RCC(13 men and 5 women;mean age,56 years,range,37 to 78 years) underwent radical nephrectomy.These cases were assigned to 2 groups.①Immuno-chemotherapy group included 13 cases (10 men and 3 women),whose tumor stages were T 1 (1 case),T 2 (8) and T 3(4).They were treated with high-dose subcutaneous interleukin-2(IL-2) in combination with interferon-?(IFN-?) and venous infusion 5-fluorouracil(5-Fu) 10 days after operation.②Control group included 5 cases (3 men and 2 women),whose tumor stages were T 1(1 case),T 2(3),T 3(1).They didn’t receive immuno-chemotherapy.The immuno-chemotherapeutic courses consisted of IL-2 (8?10 6 U,3 times/w,weeks 1 and 4;4?10 6 U,3 times/w,weeks 2 and 3);IFN-? 6?10 6 U,3 times/w,weeks 2,3,6 and 7;9?10 6 U,3 times/w,weeks 5 and 8);and 5-Fu (1000 to 1250 mg,once a week,weeks 5 to 8).Such therapeutic cycle could be repeated at 3-month intervals.Follow-up was conducted with hemogram,hepatic and renal function,ultrasonography of liver and kidney,chest X-ray every month after treatment.Long-term outcomes for these patients were analyzed. Results Follow-up of 60 to 87 months was carried out after 1 to 4 therapeutic cycles(mean,1.9 cycles) in the 13 cases of immuno-chemotherapy.Of them,12 cases experienced cancer-free survival.Only 1 case had metastasis in thigh bone 43 months after operation.No severe side effects occurred.5 cases in control group were found with metastasis in 3 to 14 months after operation.The mean survival of control group was 12.8 months (range,6 to 21 months). Conclusions Immuno-chemotherapy with high-dose subcutaneous IL-2 in combination with IFN-? and venous infusion of 5-Fu is safe and effective in prevention of the recurrence and metastasis of RCC.