Low-dose cisplatin-5-fluorouracil prevents postoperative suppression of natural killer cell activity in patients with gastrointestinal cancer.
BACKGROUND
The effect of administering low-dose cisplatin (CDDP)-5-fluorouracil (5-FU) postoperatively on the activity of the immune system is not known. To clarify the effect on natural killer (NK) cell activity of treatment with low-dose CDDP-5-FU, we compared NK cell activity after surgery for gastrointestinal cancer in patients treated with low-dose CDDP-5-FU, a bolus dose of mitomycin C (MMC) or no anticancer drug.


METHODS
Sixty-two patients consisted of three groups: low-dose CDDP-5-FU (n = 15), MMC (n = 20) and no-drug (n = 27). Chemotherapy was initiated immediately after surgery. NK cell activity was measured on the day before surgery (pre-op) and on postoperative days 7 (POD7) and 21 (POD21).


RESULTS
The NK cell activities of the CDDP-5-FU group were 37.7% at pre-op, 36.1% on POD7 and 33.6% on POD21. However, the NK cell activities in the no-drug and MMC groups were significantly decreased on POD7 (from 36.6 to 24.8% and from 31.4 to 16.6%, respectively). The NK cell activity in the MMC group remained depressed on POD21 (18.6%) whereas that in the no-drug group recovered (31.6%).


CONCLUSIONS
Consecutive administration of low-dose CDDP-5-FU appears to be useful as postoperative adjuvant chemotherapy because of its preventive effect on NK cell suppression after surgery.
Ishikawa
K
K
Department of Surgery I, Oita Medical University, Japan.
Shimoda
K
K
Shiraishi
N
N
Adachi
Y
Y
Kitano
S
S
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003082:Colectomy; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000276:immunology* / Q000601:surgery; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D005743:Gastrectomy; D006801:Humans; D007694:Killer Cells, Natural / Q000187:drug effects / Q000276:immunology*; D007970:Leukopenia / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000276:immunology* / Q000601:surgery; D012007:Rectum / Q000601:surgery; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000276:immunology* / Q000601:surgery
D002945:Cisplatin; D005472:Fluorouracil