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一项针对III期胃癌的辅助联合化疗免疫治疗试验。

A trial of adjuvant combination chemoimmunotherapy for stage III carcinoma of stomach.

作者信息

Akiyoshi T, Kawaguchi M, Arinaga S, Miyazaki S, Koba F, Wada T, Tsuji H

出版信息

J Surg Oncol. 1984 Jun;26(2):86-90. doi: 10.1002/jso.2930260204.

Abstract

A chemoimmunotherapy program designed on the basis of experimental results was administered to 27 patients with stage III carcinoma of stomach following curative resection. The treatment regimen consisted of active immunotherapy with Vibrio cholerae neuraminidase (VCN)-treated autologous tumor cells admixed with bacillus Calmette-Guérin (BCG) and chemotherapy with drugs such as cyclophosphamide (CY), mitomycin C (MMC), and 5-fluorouracil (FU) which proved to enhance the immune response when administered at optimal dose and timing. Then, it was followed by long-term administration of tegafur (FT) and immunomodulators. This treatment significantly improved survival when compared to that of 41 historical control patients treated with surgery alone (P less than 0.001). As compared to 31 control patients concurrently treated with a bolus dose of MMC followed by long-term FT and immunomodulators, survival had a tendency, but not significantly, to be improved in patients treated with this therapy (P less than 0.1). However, the survival rate at 4.5 years was significantly higher than that of control patients (P less than 0.01). These results appeared to show that this type of adjuvant combination chemoimmunotherapy may be of benefit for this group of patients with gastric carcinoma.

摘要

根据实验结果设计的化疗免疫治疗方案应用于27例胃癌根治性切除术后的Ⅲ期患者。治疗方案包括用霍乱弧菌神经氨酸酶(VCN)处理的自体肿瘤细胞与卡介苗(BCG)混合进行主动免疫治疗,以及使用环磷酰胺(CY)、丝裂霉素C(MMC)和5-氟尿嘧啶(FU)等药物进行化疗,这些药物在以最佳剂量和时间给药时被证明可增强免疫反应。然后,接着长期给予替加氟(FT)和免疫调节剂。与41例仅接受手术治疗的历史对照患者相比,这种治疗显著提高了生存率(P小于0.001)。与31例同时接受大剂量MMC然后长期使用FT和免疫调节剂治疗的对照患者相比,接受该疗法治疗的患者生存率有提高的趋势,但无显著差异(P小于0.1)。然而,4.5年时的生存率显著高于对照患者(P小于0.01)。这些结果似乎表明,这种辅助性联合化疗免疫治疗可能对这组胃癌患者有益。

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