Nimura Hiroshi, Mitsumori Norio, Takahashi Naoto, Kashimura Hirotaka, Takayama Sumio, Kashiwagi Hideyuki, Yanaga Katsuhiko
Dept of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
Gan To Kagaku Ryoho. 2006 Jun;33 Suppl 1:106-9.
Lentinan (LNT) is a beta-glucan known to have a life-prolonging effect in combination with chemotherapy for patients with unresectable or recurrent gastric cancer. Thus, a multi-center trial of chemo-immunotherapy using S-1 combined with LNT may benefit patients with unresectable or recurrent gastric cancer with acceptable toxicity. With such a regimen, the median survival time in 32 patients was 559 days. Regardless of change to second-line chemotherapy, the mean period of using S-1+LNT for patients with long NC above 400 days was 725 days. In subset analyses, the survival period of the patients with G/L ratio of equal to or less than 2 was significantly better than that of the higher one (p<0.0001). The incidence of hematological toxicity (grade 3 leukopenia and thrombocytopenia) was 6.3% (2/32), and non-hematological toxicity (grade 2 dysgeusia) was 6.3% (2/32), while no grade 4 toxicity was observed. S-1 and LNT combination immunotherapy was carried out safely with high QOL and allowed a prolonged administration. S-1+LNT regimen may prolong NC periods in patients with unresectable or recurrent gastric cancer.
香菇多糖（LNT）是一种β-葡聚糖，已知其与化疗联合使用时，对不可切除或复发性胃癌患者具有延长生存期的作用。因此，一项使用S-1联合LNT进行化学免疫治疗的多中心试验，可能会使不可切除或复发性胃癌患者受益，且毒性可接受。采用这种治疗方案，32例患者的中位生存时间为559天。无论是否改为二线化疗，NC时间超过400天的患者使用S-1+LNT的平均时间为725天。在亚组分析中，G/L比值等于或小于2的患者生存期明显优于比值较高的患者（p<0.0001）。血液学毒性（3级白细胞减少和血小板减少）的发生率为6.3%（2/32），非血液学毒性（2级味觉障碍）为6.3%（2/32），未观察到4级毒性。S-1与LNT联合免疫治疗安全性高，生活质量良好，且可长期给药。S-1+LNT方案可能会延长不可切除或复发性胃癌患者的NC期。
