Mise K, Kan N, Okino T, Moriguchi Y, Harada T, Ichinose Y, Inoue K
First Department of Surgery, Kyoto University, Faculty of Medicine, Japan.
Surg Today. 1994;24(1):54-8. doi: 10.1007/BF01676886.
Prognostic factors, such as preoperative status, intraoperative findings, and postoperative treatments, were evaluated in 61 patients with peritoneal metastasis from gastric cancer treated in our facility between 1979 and 1991. Since 1986, 23 patients have been treated with OK-432-combined adoptive immunotherapy (AIT). OK-432-combined AIT is a sequential treatment via a catheter inserted into the abdominal cavity, using a streptococcal preparation, OK-432, followed by the transfer of lymphocytes cultured with T cell growth factor and sonicated tumor extract. A univariate analysis showed that six factors consisting of: (1) age, (2) resection of primary lesion, (3) grade of peritoneal metastasis or serosal invasion, (4) chemotherapy, (5) OK-432, and (6) OK-432-combined AIT influenced survival. The survival of the patients given OK-432-combined AIT (median survival time; MST = 7.5 months) was significantly (P = 0.0267) longer than that of those not receiving OK-432-combined AIT (MST = 4.3 months). A multivariate analysis showed that the most significant factors associated with survival were chemotherapy, resection of the primary lesion, and OK-432-combined AIT. Since these three factors are all therapeutic procedures, the use of combination therapy including OK-432-combined AIT is thus expected to prolong the survival of gastric cancer patients with peritoneal metastasis.
我们对1979年至1991年间在我院接受治疗的61例胃癌腹膜转移患者的预后因素进行了评估,这些因素包括术前状态、术中发现及术后治疗。自1986年起,23例患者接受了OK-432联合过继性免疫疗法(AIT)。OK-432联合AIT是一种通过插入腹腔的导管进行的序贯治疗,使用链球菌制剂OK-432,随后转移用T细胞生长因子和超声破碎的肿瘤提取物培养的淋巴细胞。单因素分析显示,以下六个因素影响生存:(1)年龄,(2)原发灶切除,(3)腹膜转移或浆膜侵犯程度,(4)化疗,(5)OK-432,(6)OK-432联合AIT。接受OK-432联合AIT的患者的生存期(中位生存期;MST = 7.5个月)显著(P = 0.0267)长于未接受OK-432联合AIT的患者(MST = 4.3个月)。多因素分析显示,与生存相关的最显著因素是化疗、原发灶切除和OK-432联合AIT。由于这三个因素均为治疗手段,因此使用包括OK-432联合AIT在内的联合治疗有望延长胃癌腹膜转移患者的生存期。