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临床实践中多糖K(PSK)用于Ⅲ期直肠癌的治疗

[Administration of polysaccharide K (PSK) for stage III rectal cancer in clinical practice].

作者信息

Ishibashi Keiichiro, Hokama Naoko, Ishiguro Toru, Kuwabara Kouki, Okada Norimichi, Ohsawa Tomonori, Miyazaki Tatsuya, Yokoyama Masaru, Ishida Hideyuki

机构信息

Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University.

出版信息

Gan To Kagaku Ryoho. 2009 Nov;36(12):1975-8.

Abstract

This retrospective study was performed to examine the frequency of PSK administration in patients with Stage III rectal cancer in clinical practice, and the effect of PSK on patient outcome. The subjects were 71 patients with Stage III rectal cancer who received postoperative adjuvant chemotherapy comprising fluoropyrimidines between April 1997 and March 2006. The frequency of PSK administration and factors affecting recurrence, disease-free survival, and overall survival were examined. The frequency of concomitant use of PSK with fluoropyrimidines was 79% (56 patients). Among the patients who were given PSK, the frequency of concomitant use of UFT alone was higher in Stage III a patients, while the rate of concomitant use of fluoropyrimidines and Leucovorin was higher in Stage III b patients (p<0.01). Multivariate analyses revealed that the only predictive factor affecting recurrence, disease-free survival, and overall survival was Stage III b. Although the rate of concomitant use of PSK in adjuvant chemotherapy for patients with Stage III rectal cancer was high, we did not evaluate the effect of PSK because there was a marked bias in relation to the subclassification of Stage III disease and the use of Leucovorin in these subjects. Prospective randomized trials with stratification of Stage III disease will be needed in the future to validate the efficacy of PSK.

摘要

本回顾性研究旨在探讨临床实践中III期直肠癌患者服用PSK的频率,以及PSK对患者预后的影响。研究对象为1997年4月至2006年3月期间接受含氟嘧啶辅助化疗的71例III期直肠癌患者。研究了PSK的服用频率以及影响复发、无病生存期和总生存期的因素。PSK与氟嘧啶联合使用的频率为79%(56例患者)。在服用PSK的患者中,III a期患者单独使用优福定的频率较高,而III b期患者氟嘧啶与亚叶酸联合使用的频率较高(p<0.01)。多因素分析显示,影响复发、无病生存期和总生存期的唯一预测因素是III b期。虽然III期直肠癌患者辅助化疗中PSK联合使用的比例较高,但由于这些受试者在III期疾病的亚分类和亚叶酸使用方面存在明显偏差,我们未评估PSK的效果。未来需要进行III期疾病分层的前瞻性随机试验,以验证PSK的疗效。

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