vaccines. Similarly, there is no role for hormone manipulation (female hormone progesterone) or chemotherapy (vinblastine). Any of the above therapies should only be given as part of an investigational randomized study.
Radiation Although radiation therapy can control bone and brain lesions, it has not success
fully prevented local tumor recurrence , nor has improvement in survival been definitely shown with radiation given before or after surgery.
Chemotherapy The most effective standard chemotherapy drugs for metastatic disease are
vinblastine and nitrosoureas— lomustine (CCNU) and carmustine (BCNU)—which produce tumor regression in only 5 to 10 percent of cases. Combination chemotherapy regimens have not yet demonstrated any superiority to single-drug therapy.
Biological Therapy Interferon-alpha reduces tumors in 10 to 30 percent of patients, mostly those
with lymph node and lung metastases. The usual dose of 6 to 9 million units—self-administered under
the skin in the thigh three times weekly—should be continued for about three months before a decision is made about its effectiveness. Interferon-alpha—which is not yet licensed by the FDA for this disease despite response rates similar to interleukin-2 (IL-2)—must still be considered investigational. IL-2 , with or without your own lymphokine-activated killer (LAK) or tumor-infiltrating lymphocytes (TIL), is licensed because a few
