Grem J L
Oncology (Williston Park). 1991 Mar;5(3):63-70, 73; discussion 73-4.
Levamisole, an anthelminthic drug, has been studied clinically as a nonspecific immunomodulator in the adjuvant treatment of a variety of malignancies. Over a decade ago, a small, non-randomized trial of levamisole versus no further therapy after primary surgical resection of colorectal carcinoma showed a survival benefit for the cohort receiving levamisole, particularly among patients with transmural penetration or positive regional nodes. Since this seminal trial, numerous adjuvant trials of levamisole alone or in combination with 5-fluorouracil have been conducted. Two randomized, placebo-controlled trials failed to show a benefit of levamisole in patients with node-positive colon carcinoma. Three adjuvant trials have shown a therapeutic benefit of levamisole plus 5-fluorouracil compared to observation. Adjuvant therapy with levamisole and 5-fluorouracil reduced the risk of cancer recurrence by 41% and the death rate by 33% in patients with node-positive disease. The results of this trial have defined a new standard of care in the treatment of patients with Stage C colon carcinoma.
左旋咪唑是一种驱虫药，已作为非特异性免疫调节剂用于多种恶性肿瘤的辅助治疗，并进行了临床研究。十多年前，一项关于左旋咪唑与结直肠癌初次手术切除后不再接受进一步治疗的小型非随机试验表明，接受左旋咪唑治疗的队列患者有生存获益，尤其是在肿瘤穿透肠壁或区域淋巴结阳性的患者中。自这项具有开创性的试验以来，已经开展了许多关于单独使用左旋咪唑或与5-氟尿嘧啶联合使用的辅助试验。两项随机、安慰剂对照试验未能显示左旋咪唑对淋巴结阳性结肠癌患者有益。三项辅助试验表明，与观察相比，左旋咪唑加5-氟尿嘧啶有治疗益处。左旋咪唑和5-氟尿嘧啶的辅助治疗使淋巴结阳性疾病患者的癌症复发风险降低了41%，死亡率降低了33%。该试验结果为C期结肠癌患者的治疗确定了新的护理标准。
