Sakai Toshimi, Yamashita Yuichi, Maekawa Takafumi, Mikami Kouji, Hoshino Seiichiro, Shirakusa Takayuki
Department of Surgery, Fukseikai Hospital, Fukuoka, Japan.
Cancer Biother Radiopharm. 2008 Aug;23(4):461-7. doi: 10.1089/cbr.2008.0484.
Long-term survival, which extends beyond 5 years, is a desired outcome for colorectal cancer patients. In the present study, we retrospectively compared the 10-year overall survival between the control group and the polysaccharide kureha (PSK) group and analyzed the factors influencing the prognosis. The control group was treated exclusively with oral fluoropyrimidines, whereas the PSK group was treated with fluoropyrimidines, given in conjunction with PSK for 24 months. The 10-year survival rates for the PSK group (81.9%) were significantly superior to those of the control group (50.6%). In Dukes' C cases, the 10-year overall survival rates for the PSK group were also significantly higher than those of the control group. In cases with lymphatic invasion graded ly2-ly3 or venous invasion graded v2-v3, the 10-year overall survival rates were 80.6% in the PSK group, which were significantly superior, compared to 25.9% in the control group. Analysis by Cox's proportional hazard model showed a significant difference between the control and PSK groups. These results indicate that postoperative adjuvant immunochemotherapy with PSK greatly improves prognosis at 10 years. On the basis of these results, we recommend postoperative adjuvant immunochemotherapy combined with PSK for patients with Dukes' C and in cases with ly2-ly3 or v2-v3 invasion.
超过5年的长期生存是结直肠癌患者期望的结果。在本研究中,我们回顾性比较了对照组和香菇多糖(PSK)组的10年总生存率,并分析了影响预后的因素。对照组仅接受口服氟嘧啶治疗,而PSK组接受氟嘧啶治疗,并联合PSK治疗24个月。PSK组的10年生存率(81.9%)显著高于对照组(50.6%)。在杜克C期病例中,PSK组的10年总生存率也显著高于对照组。在淋巴管浸润分级为ly2-ly3或静脉浸润分级为v2-v3的病例中,PSK组的10年总生存率为80.6%,显著高于对照组的25.9%。Cox比例风险模型分析显示对照组和PSK组之间存在显著差异。这些结果表明,PSK术后辅助免疫化疗可显著改善10年预后。基于这些结果,我们建议对杜克C期以及ly2-ly3或v2-v3浸润的患者采用PSK联合术后辅助免疫化疗。