The prognosis for metastatic renal cell carcinoma is poor, and also there is no effective treatment for this cancer. Recombinant interferon alpha-2a displays subadditive. additive, and synergic effects when used with a number of cytotoxic agents is vitro and in vivo tumor models. A total of 3l petients with metastatic renal cell carcinoma was recieved recombinant interferon alpha-2a, vinblastine, CCNU and medroxyprogesterone acetate between March 1988 and December 1993. Their mean age was 53.8 years (range; 14 - 78 years).The male to female ratio was 2.1:1. Histologically, clear cell type was dominant (83.8%).Lung metastasis only was in 13 cases(41.9%) and multiple metastasis was in 18cases.Using the deKerion criteria for response, the response rate was 29%(9 cases). The 1,2,5 year survival rates of all the patients were 48%, 18%, 18% respectively, 100%, 60%, 60% for the responder group and 24%, 8%, 0% for the nonresponder (p=0.004).In combination chemothetherapy with recombinant interferon alpha-2a, the Karnofsky performance index was the most significant prognostic factor(p=0.015). Age, sex, metastatic sites, cell type and disease free interval had no significance(p>0.05).The most common side effects were constitutional symptoms(93.5%).Hematologic toxicity(41.9%),G-I toxicity(41.9%) and hepatic toxicity(6%) occured. In conclusions, combination chemotherapy with recombinant interferon alpha-2a raised remssion and survival rates and can be on effective palliative therapy in patients with metastatic renal cell carcinoma.
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