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[术前联合治疗:对胃癌患者局部给予非特异性免疫激活制剂(OK-432)及化疗制剂]

[Preoperative combination therapy involving local administration of a non-specific immunoactivated preparation (OK-432) and chemotherapeutic preparations for patients with stomach cancer].

作者信息

Mukai M, Ryu S, Kikuchi T, Ariga T, Nagashima T, Koh Z, Yamazaki Y, Odaka M, Satoh H, Nagao K

出版信息

Gan To Kagaku Ryoho. 1985 Apr;12(4):880-6.

PMID:3920972
Abstract

OMF therapy, which is a combination therapy consisting of OK-432 administered locally, Mitomycin C and 5-Fluorouracil, was administered to 50 cases of stomach cancer (52 episodes) preoperatively. Judging the criterion for a positive (+) effect as being the existence of degeneration or necrosis in 1/3-1/2 of carcinomas visible within whole fields, the ratio of histological effectiveness shown by this therapy was 75%. As for its effect on metastatic foci of lymph nodes, when 70 case from an n1 group and 8 from an n2 group with metastatic positive lymph nodes, including 17 cases (4 in Stage II and 13 in Stage III) ablated for curing were studied, a greater than positive (+) effect was shown in 51 out of the total of 78. Consequently the effective ratio was 65%. The survival ratio of 16 cases in Stage III on the 48th month calculated by the Kaplan Meier method was 78.6%. The survival time of 50% of 9 cases in Stage IV (absolute non-curing ablation) was 15 months. Tissue samples were examined constantly after local administration of OK-432. Exudation of neutrocytes was shown on the 1st day, and that of histiocytes, lymphocytes and plasmacytes on the 4th day. At this stage, degeneration of the primary focus or necrotizing change was observed. Interstitial reaction peaked on the 14th day, but histiocytes tended to decrease.

摘要

OMF疗法是一种由局部注射OK-432、丝裂霉素C和5-氟尿嘧啶组成的联合疗法,术前对50例胃癌患者(52例次)进行了治疗。将全视野内可见癌组织1/3 - 1/2出现变性或坏死判定为阳性(+)效应标准,该疗法的组织学有效率为75%。关于其对淋巴结转移灶的影响,对70例n1组和8例n2组伴有阳性转移淋巴结(包括17例为根治性切除,其中II期4例,III期13例)的患者进行研究,78例中51例显示出大于阳性(+)的效应。因此有效率为65%。采用Kaplan Meier法计算,III期16例患者第48个月的生存率为78.6%。IV期9例(绝对无法根治性切除)患者中50%的生存时间为15个月。局部注射OK-432后持续检查组织样本。第1天可见中性粒细胞渗出,第4天可见组织细胞、淋巴细胞和浆细胞渗出。此时,观察到原发灶变性或坏死改变。间质反应在第14天达到峰值,但组织细胞趋于减少。

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