Enhancement of radiation effects by alpha interferon in the treatment of small cell XXXX .

@entity1 @entity82 @entity4153 @entity5 @entity2 @entity3027
The effects on lung tissue and @entity5 of natural @entity1 @entity3027 and radiotherapy were investigated in a multimodality treatment program for selected @entity1 with small cell @entity2 ( @entity4153 ). Interferon was given first as a single agent, then concomitantly with radiotherapy to 12 previously untreated @entity1 with limited disease. At disease progression outside the chest, interferon was discontinued and combination chemotherapy was initiated. In the first series, 7 @entity1 received a high interferon induction dose (800 X 10(6) IU i.v. over 5 days) followed by low-dose maintenance therapy (6 X 10(6) IU i.m. TIW), median total dose 1380 X 10(6) IU (range 794-2074). At local progression, split-course radiotherapy, 55 Gy/20 F/7 wk, was added to interferon therapy. In the second series, 5 @entity1 received low-dose interferon from the start (6 X 10(6) IU i.m. daily) combined with twice-a-day fractionated radiotherapy 44 Gy/40 F/4 wk. Median total dose of interferon in this series was 698 X 10(6) IU (range 354-828). @entity5 response and normal tissue reactions were evaluated by monthly chest X rays, 3-monthly CT scans, restaging bronchoscopies and by serial respiratory function tests. Autopsy specimens from both lungs within and outside the radiation field were systematically evaluated when available. After the completion of radiotherapy, there were 4/7 CR in the high-dose @entity3027 group compared to 3/5 CR in the low-dose @entity3027 group. Rapid shrinkage of huge @entity5 masses was observed. At 2 months post radiotherapy radiological grade III @entity82 occurred in 4/7 @entity1 in the high-dose and 1/5 @entity1 in the low-dose group. Lung function studies showed a significant decrease in diffusing capacity and in lung volumes. Seven @entity1 died within 12 months from start of interferon treatment, one of them from treatment complication. At autopsy the @entity5 area was in most cases replaced by severe @entity82 . Outside the radiation field lung @entity82 was mild. Our results suggest enhancement of radiation effect by interferon with a possible dose and/or schedule dependence of interferon and radiotherapy and call for more clinical studies of @entity3027 and radiotherapy in combination.
