インターフェロンβの局所療法による中枢神経系副作用

抄録

Interferon-β (IFN-β) is considered remarkably nontoxic compared with other anticancer drugs. Central nervous system toxicity, in particular, is very rare, only three cases having been reported (seizure in one case and deterioration of consciousness in two cases). In this study, human fibroblast interferon (Hu IFN-β with a specific activity of 2.0 × 10⁸ IU/mg protein) was administered to three patients who were marginally functioning with malignant brain tumors (two glioblastoma multiforme and one grade 2 astrocytoma with intracerebral seeding) by intraventricular and/or intratumoral injection. Deterioration of the highest integrative functions, such as spontaneity, interaction with the environment, and orientation to time, place, person, and situation were then observed. Drowsiness and deterioration of consciousness were observed in two cases. One patient, to whom IFN-β was administered through an Ommaya's reservoir into a left parietal tumor cavity, developed complete sensory aphasia. The mechanisms of these central nervous system reactions to IFN-β are unclear. Deterioration of high integrative functions and consciousness disturbance are considered to reflect global suppression of cerebral function by IFN-β access to the subarachnoid space or ventricular system. Sensory aphasia is regarded as a result of direct, local suppression of cerebral function. It is suggested that IFN-β-induced central nervous system toxicity tends to occur in patients whose cerebral function is tenuous. The possibility of central nervous system toxicity should be kept in mind when IFN-β is administered locally.