Gochi A, Fuchimoto S, Orita K, Konaga E, Okamura S, Mannami T, Sato K
First Department of Surgery, Okayama University Medical School, Japan.
Nihon Geka Gakkai Zasshi. 1989 Sep;90(9):1439-42.
Many BRMs (biological response modifiers) have been used for post-operative immunochemotherapy. And their usefulness were also reported. Nevertheless it is still unknown that which route, how much doses and which timing are the most effective to administer these drugs. We used BRMs intratumorally and preoperatively. To reconfirm the efficacy of intratumoral injection therapy randomized study was performed in gastric carcinoma. Three hundred and ninety-five cases were entered, 199 cases in group A which were treated preoperatively with OK-432 intratumorally and 196 cases in group B which were control, respectively. In the cases which had marked infiltration of lymphoid cells in tumor sites, the two year survival rate of group A was significantly better than that of group B (p less than 0.05). On the study of recurrent forms, the distal lymph node metastasis was markedly decreased in group A. The ratio of metastasis to the distal lymph nodes in group A was 5-10% lesser than that in group B on the each depth of tumor invasion. The ratio of lymph nodes metastasis was almost similar in the each group, but the number of metastatic lymph nodes was significantly reduced in high grade tumor infiltrated cases in group A (p less than 0.005). These results suggest that preoperative endoscopically intratumoral administration of OK-432 suppresses the lymph node metastasis and improves the postoperative survival rate.
许多生物反应调节剂（BRM）已被用于术后免疫化疗。其有效性也有报道。然而，这些药物最有效的给药途径、剂量和时间仍不清楚。我们在肿瘤内和术前使用了BRM。为了再次确认肿瘤内注射治疗的疗效，我们对胃癌进行了随机研究。共纳入395例患者，A组199例，术前肿瘤内注射OK-432，B组196例作为对照。在肿瘤部位有明显淋巴细胞浸润的病例中，A组的两年生存率明显高于B组（p<0.05）。在复发形式的研究中，A组远处淋巴结转移明显减少。在肿瘤侵犯的各个深度，A组远处淋巴结转移率比B组低5-10%。每组的淋巴结转移率几乎相似，但在A组高度肿瘤浸润病例中，转移淋巴结的数量明显减少（p<0.005）。这些结果表明，术前内镜下肿瘤内注射OK-432可抑制淋巴结转移并提高术后生存率。
