Activated (HLA-DR+) T-lymphocyte subsets in cervical carcinoma and effects of radiotherapy and immunotherapy with sizofiran on cell-mediated immunity and survival.
A prospective randomized trial on 312 patients with locally advanced cervical carcinoma (FIGO stages IB-IV) was carried out. The 5-year survival in 90 patients treated with radiotherapy and antitumor polysaccharide sizofiran, an extract from the culture broth of Schizophyllum commune Fries, in combination was significantly (P = 0.045) better than that in 82 patients treated with radiotherapy alone. Treatment with sizofiran and 5-fluorouracil in combination improved (P = 0.003) the 5-year survival in 60 patients treated with radiotherapy. In 244 cervical carcinoma patients, the percentage of activated CD8+ (CD8+HLA-DR+) T cells in the CD8+ T-cell subsets in peripheral lymphocytes increased significantly as the disease progressed. A similar tendency was observed in the percentage of activated CD4+ (CD4+HLA-DR+) T cells in the CD4+ T-cell subsets. These immunologic parameters were significantly increased by radiotherapy, but not by surgery. Sizofiran accelerated a recovery in the activated CD8+ T cells in the CD8+ T-cell subsets compared with that of sizofiran nontreated patients after radiotherapy. Our data show that possible immune impairment in cervical carcinoma may be caused by disturbances in cell-mediated immunity, and that sizofiran is an effective immunotherapeutic agent for cervical carcinoma because it stimulates a rapid recovery of the immunologic parameters impaired by radiotherapy.
Miyazaki
K
K
Department of Obstetrics and Gynecology, Kumamoto University School of Medicine, Japan.
Mizutani
H
H
Katabuchi
H
H
Fukuma
K
K
Fujisaki
S
S
Okamura
H
H
D016516:CD4-CD8 Ratio; D015496:CD4-Positive T-Lymphocytes; D018414:CD8-Positive T-Lymphocytes; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D005500:Follow-Up Studies; D006684:HLA-DR Antigens; D006801:Humans; D007167:Immunotherapy; D008213:Lymphocyte Activation; D018655:Lymphocyte Count; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012566:Sizofiran / Q000627:therapeutic use*; D015996:Survival Rate; D016176:T-Lymphocyte Subsets / Q000276:immunology; D002583:Uterine Cervical Neoplasms / Q000276:immunology / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*
D006684:HLA-DR Antigens; D012566:Sizofiran; D005472:Fluorouracil