Mose S, Adamietz I A, Saran F, Thilmann C, Heyd R, Knecht R, Böttcher H D
Department of Radiation Oncology, Johann Wolfgang Goethe Universität, Frankfurt am Main, Germany.
Am J Clin Oncol. 1997 Aug;20(4):407-11. doi: 10.1097/00000421-199708000-00018.
Therapeutic application of immunoglobulin is reported to be successful in radiation-induced oral and oropharyngeal mucositis. In this study the efficacy of prophylactic application of immunoglobulin was investigated. In 42 patients with head and neck cancer, postoperative radiation treatment or radiation combined with chemotherapy was performed. In 20 consecutive patients, prophylactic mucositis treatment consisted of panthenol (4 x 10 ml/day) and nystatin (4 x 1 ml/day). The 22 following patients received, supplementary to panthenol and nystatin, 800 mg (5 ml) human immunoglobulin intramuscularly once weekly. During the treatment time, the degree of mucositis was examined 3 times a week. The distribution of maximal mucositis degree revealed slightly more severe mucous membrane reaction in the control group compared with the immunoglobulin group (n.s.). The analysis of mean mucositis degrees in both groups demonstrated statistically significant differences (t test, p = 0.031) related to the entire group (n = 42) and to those 16 patients receiving radiation combined with chemotherapy. There was no significant immunoglobulin-induced effect on mucositis in patients treated by radiation alone. The time from the beginning of therapy to the first interruption could be prolonged 5 days in the immunoglobulin group (n.s.). In conclusion, it is demonstrated that the prophylactic application of immunoglobulin seems to lower the degree of radiation-induced mucositis. In comparison to the published data about therapeutically given immunoglobulin, the clinical efficacy of the prophylactic application of immunoglobulin as it is performed in this study is less evident.
据报道，免疫球蛋白在放射性口腔和口咽粘膜炎的治疗应用中取得了成功。在本研究中，对免疫球蛋白预防性应用的疗效进行了调查。42例头颈癌患者接受了术后放疗或放疗联合化疗。连续20例患者的预防性粘膜炎治疗包括泛醇（4×10ml/天）和制霉菌素（4×1ml/天）。随后的22例患者在接受泛醇和制霉菌素治疗的基础上，每周一次肌肉注射800mg（5ml）人免疫球蛋白。在治疗期间，每周检查3次粘膜炎程度。最大粘膜炎程度的分布显示，与免疫球蛋白组相比，对照组的粘膜反应略严重（无统计学意义）。两组平均粘膜炎程度的分析显示，与整个组（n = 42）以及16例接受放疗联合化疗的患者相比，存在统计学显著差异（t检验，p = 0.031）。对于仅接受放疗的患者，免疫球蛋白对粘膜炎没有显著影响。免疫球蛋白组从治疗开始到首次中断的时间可延长5天（无统计学意义）。总之，研究表明免疫球蛋白的预防性应用似乎可以降低放射性粘膜炎的程度。与已发表的关于治疗性应用免疫球蛋白的数据相比，本研究中免疫球蛋白预防性应用的临床疗效不太明显。
