Kim J P
Department of Surgery, Seoul National University Hospital, Korea.
Ann Acad Med Singap. 1988 Jan;17(1):48-54.
To evaluate the effectiveness of adjuvant immunochemotherapy in advanced adenocarcinoma of stomach, patients who had undergone radical subtotal gastrectomy for stage III gastric carcinoma were randomized to receive immunochemotherapy or not. For immunotherapy, streptococcus pyogenes preparation (picibanil) was given intramuscularly every week and for chemotherapy, either MFC (mitomycin-C, 5-fluorouracil and cytosine arabinoside) regimen or FME (5-fluorouracil and methyl-CCNU) regimen was given. Immunotherapy was started at the 4th or 5th postoperative day and chemotherapy was started at the 8th to 10th postoperative day. To evaluate the immune status of patients, various immune parameters such as 1-chloro-2, 4-dinitrobenzene (DNCB) test, T-lymphocyte count, PHA- and concanavalin-A stimulated lymphoblastogenesis and antibody dependent cellular cytotoxicity (ADCC) activity were checked before operation and 3 to 4 months after operation. One hundred and thirty-eight patients were chosen for study during a 5-year period. Seventy-four patients received postoperative immunochemotherapy and 64 patients received no further anticancer therapy following operation. All patients had been followed at least for 5 years since they underwent operation. Survival rate and immune status were compared between two groups. Patient characteristics and preoperative values for immune status of two groups were similar to each other. Five-year survival rate of postoperative immunochemotherapy group was 44.6%, whereas that of surgery alone group was 23.4%. The difference is statistically significant (p less than 0.05). All the postoperative values of immune parameters showed more favourable data in the postoperative immunochemotherapy group.(ABSTRACT TRUNCATED AT 250 WORDS)
为评估辅助免疫化疗在晚期胃癌中的疗效,对因III期胃癌接受根治性胃次全切除术的患者进行随机分组,一组接受免疫化疗,另一组不接受。免疫治疗方面,每周肌肉注射化脓性链球菌制剂(匹克次比宁);化疗方面,给予MFC(丝裂霉素-C、5-氟尿嘧啶和阿糖胞苷)方案或FME(5-氟尿嘧啶和甲基环己亚硝脲)方案。免疫治疗于术后第4或5天开始,化疗于术后第8至10天开始。为评估患者的免疫状态,在手术前及术后3至4个月检查各种免疫参数,如1-氯-2,4-二硝基苯(DNCB)试验、T淋巴细胞计数、PHA和刀豆蛋白A刺激的淋巴细胞生成以及抗体依赖性细胞毒性(ADCC)活性。在5年期间选择了138例患者进行研究。74例患者接受术后免疫化疗,64例患者术后未接受进一步的抗癌治疗。所有患者自手术以来至少随访了5年。比较两组的生存率和免疫状态。两组患者的特征和术前免疫状态值相似。术后免疫化疗组的5年生存率为44.6%,而单纯手术组为23.4%。差异具有统计学意义(p小于0.05)。术后免疫化疗组所有免疫参数的术后值均显示出更有利的数据。(摘要截断于250字)