Caprotti R, Brivio F, Fumagalli L, Nobili C, Degrate L, Lissoni P, Parolini D, Messina G, Colciago M, Scotti M, Uggeri F
Department of General Surgery, San Gerardo Hospital, Monza, Milan, Italy.
Anticancer Res. 2008 May-Jun;28(3B):1951-4.
The treatment of pancreatic cancer is still rudimentary, even in the case of locally limited tumors, because of the high frequency of recurrence due to severe suppression of the anticancer immunity that is further amplified by surgery-induced immunosuppression, evidenced by a decline in lymphocyte numbers during the postoperative period. Previous studies in colorectal cancer demonstrated that surgery-induced lymphocytopenia may be abrogated by a brief preoperative administration of IL-2.
The study included 30 consecutive patients who were randomized to be treated by radical surgery alone as a control group or by a preoperative immunotherapy with IL-2 (12 MIU/day SC for 3 consecutive days) plus surgery.
Mean lymphocyte numbers significantly decreased in patients treated with surgery only, whereas it significantly rose in the IL-2-treated group. After a follow-up of 36 months, both the free-from-progression period (FFPP) and the overall survival were significantly higher in patients treated with IL-2.
These preliminary results suggest that a short-period preoperative immunotherapy with IL-2 is sufficient to modify host tumor interactions in operable pancreatic cancer, with a subsequent abrogation of postoperative lymphocytopenia and a prolongation of FFPP and overall survival time.
胰腺癌的治疗仍然很初级,即使是局部局限性肿瘤的情况也是如此,这是因为抗癌免疫受到严重抑制导致复发频率很高,而手术诱导的免疫抑制会进一步加剧这种情况,术后淋巴细胞数量下降就证明了这一点。先前对结直肠癌的研究表明,术前短暂给予白细胞介素-2(IL-2)可能会消除手术诱导的淋巴细胞减少。
该研究纳入了30例连续患者,这些患者被随机分为两组,一组仅接受根治性手术作为对照组,另一组接受术前IL-2免疫治疗(连续3天皮下注射12 MIU/天)加手术治疗。
仅接受手术治疗的患者平均淋巴细胞数量显著下降,而IL-2治疗组的平均淋巴细胞数量显著上升。随访36个月后,IL-2治疗的患者无进展生存期(FFPP)和总生存期均显著更长。
这些初步结果表明,术前短期使用IL-2进行免疫治疗足以改变可手术胰腺癌患者体内宿主与肿瘤的相互作用,随后消除术后淋巴细胞减少,并延长无进展生存期和总生存时间。