Nagahashi Shoichi, Suzuki Hidekazu, Nishiwaki Makoto, Okuda Kouichi, Kurosawa Yoshitomo, Terada Souichirou, Sugihara Tatsuo, Andou Koushi, Hibi Toshihumi
Dept of Internal Medicine, Hamamatsu Red Cross Hospital.
Gan To Kagaku Ryoho. 2004 Nov;31(12):1999-2003.
It is reported that TS-1 administered orally shows a significant anti-neoplasm effect on advanced gastric cancer, and, furthermore, approximately 70% or greater effectiveness is reported for combination chemotherapy with cisplatin (CDDP). Lentinan is reported to extend the survival period in advanced cancer, and in combination with Tegafur. In the present study, combination chemotherapy with TS-1/CDDP/Lentinan was conducted for patients with inoperable advanced gastric cancer, and the validity, safety and resultant QOL of the treatment were evaluated. TS-1 was administered for 3 weeks at 80 mg/m2, followed by withdrawal for 2 weeks, and CDDP was prescribed once for patients at 70 mg/m2 on the 8th day after starting TS-1 administration. For patients aged 80 or above, however, the dose was reduced, and given separately to the patients. Lentinan was administered at 2 mg/week. The rate of effectiveness for the 9 registered patients was 100%. This high rate was obtained regardless of changes in the histopathological findings. Critical side effects (grade three or above) were anemia and pigmentation, in one case each. An improvement in QOL was also observed for combination therapy including Lentinan. In cases of inoperable advanced gastric cancer, TS-1/CDDP combination chemotherapy showed higher efficacy regardless of the pathological alterations, and higher and sustained improvement of QOL was also observed with the addition of Lentinan to the protocol.
据报道,口服TS-1对晚期胃癌显示出显著的抗肿瘤作用,此外,据报道其与顺铂(CDDP)联合化疗的有效率约为70%或更高。据报道,香菇多糖可延长晚期癌症患者的生存期,且可与替加氟联合使用。在本研究中,对无法手术的晚期胃癌患者进行了TS-1/CDDP/香菇多糖联合化疗,并评估了该治疗的有效性、安全性及由此产生的生活质量。TS-1以80mg/m²的剂量给药3周,随后停药2周,CDDP在开始给予TS-1后的第8天以70mg/m²的剂量给患者单次给药。然而,对于80岁及以上的患者,剂量减少,并分别给药。香菇多糖以2mg/周的剂量给药。9例登记患者的有效率为100%。无论组织病理学结果如何变化,均获得了如此高的有效率。严重副作用(三级或以上)分别为贫血和色素沉着各1例。在包括香菇多糖的联合治疗中也观察到生活质量的改善。在无法手术的晚期胃癌病例中,TS-1/CDDP联合化疗无论病理改变如何均显示出更高的疗效,并且在方案中加入香菇多糖后也观察到生活质量有更高且持续的改善。