Immunochemosurgery as a new approach to reasonable treatment of advanced cancer.
To evaluate the effectiveness of adjuvant immunochemotherapy in advanced adenocarcinoma of stomach, patients who had undergone radical subtotal gastrectomy for stage III gastric carcinoma were randomized to receive immunochemotherapy or not. For immunotherapy, streptococcus pyogenes preparation (picibanil) was given intramuscularly every week and for chemotherapy, either MFC (mitomycin-C, 5-fluorouracil and cytosine arabinoside) regimen or FME (5-fluorouracil and methyl-CCNU) regimen was given. Immunotherapy was started at the 4th or 5th postoperative day and chemotherapy was started at the 8th to 10th postoperative day. To evaluate the immune status of patients, various immune parameters such as 1-chloro-2, 4-dinitrobenzene (DNCB) test, T-lymphocyte count, PHA- and concanavalin-A stimulated lymphoblastogenesis and antibody dependent cellular cytotoxicity (ADCC) activity were checked before operation and 3 to 4 months after operation. One hundred and thirty-eight patients were chosen for study during a 5-year period. Seventy-four patients received postoperative immunochemotherapy and 64 patients received no further anticancer therapy following operation. All patients had been followed at least for 5 years since they underwent operation. Survival rate and immune status were compared between two groups. Patient characteristics and preoperative values for immune status of two groups were similar to each other. Five-year survival rate of postoperative immunochemotherapy group was 44.6%, whereas that of surgery alone group was 23.4%. The difference is statistically significant (p less than 0.05). All the postoperative values of immune parameters showed more favourable data in the postoperative immunochemotherapy group.(ABSTRACT TRUNCATED AT 250 WORDS)
Kim
J P
JP
Department of Surgery, Seoul National University Hospital, Korea.
D000230:Adenocarcinoma / Q000401:mortality / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001688:Biological Products / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D016685:Mitomycin; D008937:Mitomycins / Q000008:administration & dosage; D010844:Picibanil / Q000627:therapeutic use*; D011897:Random Allocation; D012673:Semustine / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000401:mortality / Q000628:therapy*; D013601:T-Lymphocytes / Q000145:classification; D013997:Time Factors
D001688:Biological Products; D008937:Mitomycins; D003561:Cytarabine; D012673:Semustine; D010844:Picibanil; D016685:Mitomycin; D005472:Fluorouracil