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[结肠癌的辅助全身化疗或免疫治疗]

[Adjuvant systemic chemo- or immunotherapy of colon cancer].

作者信息

Schlag P M

机构信息

Abteilung für Chirurgie und Chirurgische Onkologie, Robert-Rössle-Klinik für Onkologie, Max-Delbrück-Centrum für Molekulare Medizin, Universitätsklinikum Rudolf Virchow, Berlin.

出版信息

Chirurg. 1994 Jun;65(6):503-8.

PMID:8088205
Abstract

The recurrence-free and overall survival of patients with colon carcinoma in UICC stage III can be improved under a postoperative chemotherapy with 5-fluorouracil combined with the unspecific immune-modulator levamisole. The pharmacological interaction of both components is however disputed. The point is whether the therapeutic effect is achieved only through a high dose monotherapy with 5-FU or whether it can also be achieved by the specific modulation of the 5-FU with folinic acid. Possibly the prognosis for a subgroup of patients in stage II (Dukes B2) could be improved with this combination of drugs. Additionally, there are clinical experiences that the postoperative tumor cell vaccination (ASI) or the treatment with monoclonal antibodies against tumor-associated antigens (CA17-1A) might reveal more specific possibilities in immunotherapy than are provided with levamisole so far. An answer to these questions can therefore only be given by well designed and performed prospective trials.

摘要

对于国际抗癌联盟(UICC)III期结肠癌患者,术后采用5-氟尿嘧啶联合非特异性免疫调节剂左旋咪唑进行化疗,可提高无复发生存率和总生存率。然而,这两种成分的药理相互作用存在争议。关键在于治疗效果是仅通过高剂量5-氟尿嘧啶单一疗法实现,还是也可通过亚叶酸对5-氟尿嘧啶的特异性调节来实现。这种药物组合可能会改善II期(Dukes B2)部分患者的预后。此外,临床经验表明,术后肿瘤细胞疫苗接种(ASI)或使用针对肿瘤相关抗原的单克隆抗体(CA17-1A)进行治疗,在免疫治疗中可能会比目前左旋咪唑提供更具特异性的治疗方法。因此,只有通过精心设计和实施的前瞻性试验才能回答这些问题。

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