Interferon gamma in survivors of the Chernobyl power plant accident: New therapeutic option for radiation-induced fibrosis

Background: One of the remarkable clinical consequences of the Chernobyl ac cident was skin involvement, leading to extensive cutaneous fibrosis. Apart from surgery, no established treatment is available. Methods: A group of survivors, working in or present at the accident site o n April 26, 1986, and a few days thereafter, were examined, treated, and fo llowed-up in 6-month intervals from September 1991 to November 1995. Eight individuals were identified as suffering from excessive cutaneous fibrosis, Skin thickness was measured with high-frequency (20 MHz) ultrasound in a c linically well-defined target skin lesion, in addition to histologic confir mation of radiation fibrosis, Interferon gamma was scheduled for all patien ts on a low dose regimen (3 x 50 mu g/week s.c.). In 2 patients, interferon was discontinued after the first injection, due to withdrawal of consent. In 6 patients, interferon was continued for 30 months, with 1 injection wee kly for a further 6 months. Treatment was discontinued in November 1991. Fo ur patients in the treated group and 1 of the 2 patients treated only once ("untreated patients") were reexamined 1 gear later. Results: In all individuals treated for 36 months, a significant (p < 0.005 ) reduction of radiation fibrosis could be determined, in contrast to a sig nificant(p < 0.005) increase in the 2 untreated patients. Follow-up 1 year after discontinuation of the interferon treatment demonstrated significant (p < 0.005) recurrence of fibrosis. Conclusion: Low-dose interferon appears to be a safe and effective treatmen t of cutaneous radiation fibrosis following accidental exposure to high dos es of ionizing radiation. Long-term supportive therapy mag be required. (C) 1999 Elsevier Science Inc.