Suzuki M, Kimura H, Iwai N, Fujisawa T
Department of Surgery, Institute of Pulmonary Cancer Research, Chiba University School of Medicine, Chuo-ku, Chiba 260-8677, Japan.
Oncol Rep. 2000 May-Jun;7(3):545-9. doi: 10.3892/or.7.3.545.
The prognosis of patients with multilevel mediastinal lymph node metastasis remains poor notwithstanding the progress in multimodal therapy in non-small cell lung cancer. We conducted a feasible study of intermittent adjuvant chemo-immunotherapy after surgery for patients with multilevel mediastinal lymph node metastasis of non-small cell lung cancer. Eleven patients with pathologically N2 or N3 lung cancer (10, adenocarcinomas; 1, squamous cell carcinoma) were enrolled. Five completely resected cases received systemic chemo-immunotherapy and six incompletely resected cases received local chemo-immunotherapy by an indwelling catheter in the thoracic cavity. Cisplatin-based and dose-dependent anti-cancer drugs were selected on the basis of sensitivity tests. Either adoptive immunotherapy with interleukin-2 and lymphokine-activated killer cell or combination of interferon gamma# and OK432 were administered after chemotherapy. This adjuvant therapy was performed every 2-3 months after surgery for 2 years. The 2-year survival rate for all cases were 72.7% and the 2-year disease-free survival were 36.4%. The 2-year survival rate for five completely resected cases and six incompletely resected cases was 80% and 66.7%, respectively. Combined intermittent chemo-immunotherapy after surgical resection of tumors may be a promising modality to improve the survival of patients with multilevel mediastinal lymph node metastasis in non-small cell lung cancer.
尽管非小细胞肺癌的多模式治疗取得了进展，但多水平纵隔淋巴结转移患者的预后仍然很差。我们对非小细胞肺癌多水平纵隔淋巴结转移患者术后进行间歇性辅助化疗免疫治疗进行了一项可行性研究。纳入了11例病理分期为N2或N3的肺癌患者（10例腺癌；1例鳞状细胞癌）。5例完全切除的病例接受了全身化疗免疫治疗，6例不完全切除的病例通过胸腔内留置导管接受了局部化疗免疫治疗。根据敏感性试验选择以顺铂为基础的剂量依赖性抗癌药物。化疗后给予白细胞介素-2和淋巴因子激活的杀伤细胞过继免疫治疗或γ干扰素#与OK432联合治疗。术后每2-3个月进行一次这种辅助治疗，持续2年。所有病例的2年生存率为72.7%，2年无病生存率为36.4%。5例完全切除病例和6例不完全切除病例的2年生存率分别为80%和66.7%。肿瘤手术切除后联合间歇性化疗免疫治疗可能是提高非小细胞肺癌多水平纵隔淋巴结转移患者生存率的一种有前景的治疗方式。
