title: [Histopathologic evaluation of anti-tumor activity of alpha-interferon for renal cell carcinoma, especially in autoptic cases].
abstract: The anti-tumor activity of alpha-interferon (gamma-IFN-alpha A) was assessed histopathologically in 14 patients with metastasized renal cell carcinoma. Ten of the patients had undergone radical nephrectomy, two patients embolization alone, one patient no prior treatment and one patient nephrectomy in IFN therapy. IFN was given daily intramuscularly starting at the dose of 3 X 10(6) U and increased every 3 days to the maximum of 5 X 10(7) U. This treatment could be tolerated. The clinical response was evaluated according to the criteria of Koyama and Saitou. Two of the patients showed partial response, one patient minor response, five patients no change and six patients progressive disease. The clinical responders also had histopathologically detected improvement. Renal cell carcinoma of a higher grade (sarcomatoid type) or lower grade (grade II greater than or equal to), was seen frequently, and the papillary or tubular type was resistant to IFN. The clear cell type and grade III tumor was more responsive to IFN. Histopathologically, no lymphocyte infiltration into the cancer cell focus was seen and the immunologic reaction was not considered to be affected by IFN, because of the myelosuppression due to the IFN therapy and because more responders used the steroid hormone like predonizolone to prevent side effects. Fever, anorexia and general malaise were observed in all cases. Myelosuppression like leukocytopenia and/or thrombocytopenia was also observed but easily improved after cessation of IFN medication or decrease of IFN dose. Liver dysfunction was observed but spontaneous recovery without discontinuation of IFN therapy or decrease of IFN dose was seen in two cases. The disturbance of the central nervous system similar to the occurrence of abnormal EEG waves or psychosis, was a dose-limiting factor. Further studies especially to develop an appropriate method of administration and the combination with other anti-cancer agents must be studied.
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000628:therapy*; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D007370:Interferon Type I / Q000009:adverse effects / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging
chemical_list: D007370:Interferon Type I