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肺癌术后胸膜腔内注射卡介苗:缺乏疗效且可能促进肿瘤生长。

Postoperative intrapleural BCG in lung cancer: lack of efficacy and possible enhancement of tumour growth.

作者信息

Bakker W, Nijhuis-Heddes J M, Wever A M, Brutel de la Rivière A, van der Velde E A, Dijkman J H

出版信息

Thorax. 1981 Nov;36(11):870-4. doi: 10.1136/thx.36.11.870.

Abstract

Fifty-six patients out of a group of 99 with lung cancer received postoperative intrapleural BCG (Pasteur strain) in three different dosages (16 X 10(6) culturable particles (cp), 32 X 10(6) cp, and 64 X 10(6) cp). When comparing the whole group of 99 patients with a historical control group of 126 patients no statistically significant differences were found in survival and disease-free interval. The two groups were well matched in respect of age, sex, histology, stage of disease, and type of operation. Patients with epidermoid carcinoma stage I receiving BCG, however, did significantly worse than those who had not received BCG in terms of disease-free interval. This unfavourable trend was caused by earlier local recurrences rather than metastases. The possible phenomenon of enhanced tumour growth noted in or patients with epidermoid carcinoma stage I might be related to the dosages used in this study, but the different BCG strain used hinders comparison with other studies. We conclude that BCG has no beneficial effect on survival or on disease-free interval; possible enhancement of tumour growth in stage I epidermoid carcinoma was found.

摘要

99名肺癌患者中有56名在术后接受了胸膜腔内卡介苗(巴斯德菌株)治疗,剂量分为三种(16×10⁶可培养颗粒(cp)、32×10⁶ cp和64×10⁶ cp)。将这99名患者的整个群体与126名患者的历史对照组进行比较时,在生存率和无病间期方面未发现统计学上的显著差异。两组在年龄、性别、组织学、疾病分期和手术类型方面匹配良好。然而,I期表皮样癌患者接受卡介苗治疗后的无病间期明显比未接受卡介苗治疗的患者差。这种不利趋势是由早期局部复发而非转移引起的。在I期表皮样癌患者中观察到的肿瘤生长可能增强的现象可能与本研究中使用的剂量有关,但所使用的不同卡介苗菌株妨碍了与其他研究的比较。我们得出结论,卡介苗对生存率或无病间期没有有益影响;在I期表皮样癌中发现了肿瘤生长可能增强的情况。

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