Takita M, Onda M, Tokunaga A, Shirakawa T, Ikeda K, Hiramoto Y, Teramoto T, Oguri T, Fujita I, Okuda T, Mizutani T, Kiyama T, Yoshiyuki T, Matsukura N
First Dept. of Surgery, Nippon Medical School.
Gan To Kagaku Ryoho. 1998 Jan;25(1):129-33.
Satisfactory therapeutic effects are rarely obtained with oral chemotherapy for gastric cancer. We have experienced successful treatment for synchronous hepatic metastasis of gastric cancer with 5'-DFUR and Lentinan. The patient was a 78-year-old female, diagnosed as having gastric cancer with multiple hepatic metastases, who underwent gastrectomy. Immunohistochemistry of the resected specimens with anti-thymidine phosphorylase (dThdPase) antibody yielded positive results for dThdPase in the primary tumor as well as the hepatic metastases. Two months after surgery, administration of 400 mg of 5'-DFUR per day and 2 mg i.v. of Lentinan every other week was started. Four months after discharge, carcinoembryonic antigen (CEA) in plasma showed an abrupt logarithmic decline. Furthermore, a 99% reduction in hepatic metastases was demonstrated by abdominal CT. At present, 22 months after surgery, the patient is managed on an outpatient basis with no complaints of any side effects. Immunochemotherapy using 5'-DFUR and Lentinan may be effective against gastric malignancies expressing dThdPase activity.
口服化疗对胃癌的治疗效果鲜有令人满意的。我们曾用5'-脱氧氟尿苷(5'-DFUR)和香菇多糖成功治疗过胃癌同时性肝转移。患者为一名78岁女性,被诊断为胃癌伴多发肝转移,接受了胃切除术。用抗胸苷磷酸化酶(dThdPase)抗体对切除标本进行免疫组织化学检测,结果显示原发肿瘤及肝转移灶中的dThdPase均呈阳性。术后两个月开始每天给予400mg 5'-DFUR,每隔一周静脉注射2mg香菇多糖。出院后四个月,血浆癌胚抗原(CEA)呈对数性急剧下降。此外,腹部CT显示肝转移灶缩小了99%。目前,术后22个月,患者门诊治疗,无任何副作用主诉。使用5'-DFUR和香菇多糖的免疫化疗可能对表达dThdPase活性的胃恶性肿瘤有效。