腎癌に対するインターフェロン-α(IFNα)自己注射療法の現状について : 患者に対するアンケート調査より

Abstract

IFNα自己注射療法について, 患者に対しアンケート調査を行いその現状について検討した。1)コンプライアンスは非常に良く, また多くの患者が自ら注射を行っており, 患者による積極的な癌治療法として受け入れられていた。2)副作用としては, 白血球減少, 食欲不振, 全身倦怠感などが強く見られた。1例に治療開始直後に急激な白血球減少が見られたが, 他には重篤な副作用の出現もなく外来管理が可能であった。3)本療法に対する不安として, 継続期間, 治療効果に対するものが多かった。また高額な治療費も, 治療継続の大きな制限因子となる可能性があった。4)廃棄方法については, 再度患者に対する指導が必要と思われた。5)治療中止の原因は, 半数が副作用が原因であった。中止後早期に体調の回復が見られたが, 治療再開に対して消極的であった

Interferon-alpha (IFN alpha) is often used for the treatment of renal cell carcinomas. The injections are frequently self-administered at home. To assess how this therapy was accepted by the patient we sent out a questionnaire. For the past 2 years until March 1993, this therapy was performed in our department on 52 patients, of whom 45 were selected for the study. All patients were informed of their disease and consented to the necessity of this treatment. Thirty-eight patients answered this questionnaire. Almost all patients injected this agent mainly by themselves. These findings suggested that they regarded this therapy as a strategy to be executed by themselves for the treatment of carcinoma. The main toxic symptoms in this therapy were asthenia, fever and loss of appetite. Leukocytopenia occurred in about half of the patients, of whom 1 patient required medication because of a rapid decrease in the white blood cell count shortly after inception of this therapy. The treatment was discontinued in 50% of the patients because of these adverse effects. Systemic toxicity disappeared after cessation of IFN alpha administration. Additionally, over 80% of the patients expressed concern about effectiveness, the duration and high cost of this therapy. The patients had to be repeatedly instructed about the method of disposing used needles and syringes. This study revealed that self injection of IFN alpha, which required strict management particularly at the initiation, can be performed at home. However, countermeasures must be taken against the side actions and an optimum regimen of IFN alpha should be established as soon as possible.