Shibata Masahiko, Shimura Tatsuo, Nishina Yumiko, Gonda Kenji, Matsuo Sadanori, Abe Hideo, Yajima Yukihiro, Nakamura Izumi, Ohki Shinji, Takenoshita Seiichi
Dept. of Tumor and Host Bioscience, Fukushima Medical University.
Gan To Kagaku Ryoho. 2011 May;38(5):797-801.
FOLFOX4 has been proven to be effective for metastatic colorectal cancer and is now used as a postoperative adjuvant therapy. However, adverse effects such as cold-sensitive paresthesia and bone marrow suppression are common, and this may necessitate a change of chemotherapy regimen even though FOLFOX is effective. PSK, a polysaccharide derived from mushrooms, has been developed in Japan as an immune-enhancing agent, and is widely used in patients with gastric, colorectal and pulmonary cancer. PSK has also been reported to decrease some adverse effects of chemotherapy. FOLFOX4 combined with PSK was administered to patients with metastatic colorectal cancer and the results were evaluated. Eight cycles of FOLFOX4 and PSK (3.0 g/day, po) were given to 25 patients with metastatic (19 hepatic, 3 pulmonary and 3 peritoneal) colorectal cancer. There was no CR (0%), while PR, SD and PD were 48, 36 and 16%, respectively. The response rate was 48%, and the disease control rate was 84%. There were significantly lower frequencies of adverse effects in comparison with published data. Grades 1 and 3 neutropenia occurred in 48 and 24%, respectively, of the patients; grades 1 and 3 nausea in 48 and 4%; and grades 1, 2 and 3 sensory neurotoxicity in 52, 4 and 0%. No patient dropped out due to adverse effect in this study. PSK plus FOLFOX4 seemed to be as effective as FOLFOX4 monotherapy as has been published, and significantly less toxic. These results suggest that this combination therapy may be more effective than FOLFOX4 monotherapy when given over a longer period, with a lower incidence of adverse effects.
FOLFOX4已被证明对转移性结直肠癌有效，目前用作术后辅助治疗。然而，诸如冷敏性感觉异常和骨髓抑制等不良反应很常见，这可能需要改变化疗方案，尽管FOLFOX4有效。PSK是一种从蘑菇中提取的多糖，在日本已被开发为免疫增强剂，并广泛用于胃癌、结直肠癌和肺癌患者。据报道，PSK还可减轻化疗的一些不良反应。对转移性结直肠癌患者给予FOLFOX4联合PSK，并对结果进行评估。对25例转移性（19例肝转移、3例肺转移和3例腹膜转移）结直肠癌患者给予8个周期的FOLFOX4和PSK（3.0 g/天，口服）。无完全缓解（CR）病例（0%），部分缓解（PR）、疾病稳定（SD）和疾病进展（PD）分别为48%、36%和16%。缓解率为48%，疾病控制率为84%。与已发表的数据相比，不良反应的发生率显著降低。1级和3级中性粒细胞减少分别发生在48%和24%的患者中；1级和3级恶心分别发生在48%和4%的患者中；1级、2级和3级感觉神经毒性分别发生在52%、4%和0%的患者中。本研究中没有患者因不良反应而退出。PSK加FOLFOX4似乎与已发表的FOLFOX4单药治疗效果相同，但毒性显著更低。这些结果表明，这种联合治疗在长期应用时可能比FOLFOX4单药治疗更有效，且不良反应发生率更低。
