title: Effects of preoperative immunochemoradiotherapy and chemoradiotherapy on immune responses in patients with rectal adenocarcinoma.
abstract: BACKGROUND
  We previously reported that preoperative chemoradiotherapy (CRT) combined with intraoperative electron irradiation for cT3/T4 adenocarcinoma of the rectum reduced the local recurrence, with significant improvement of survival. Radiotherapy has been reported to reduce immune function. We examined the effects of PSK, a protein-bound polysaccharide, concomitant with preoperative CRT on immune responses.
  
  
  METHODS
  Thirty patients with cT3/T4 adenocarcinoma of the rectum were randomly assigned to 2 weeks' irradiation and 4 weeks' S-1 administration before surgery (control group), or the same CRT with simultaneous 4 weeks' PSK administration (PSK group). Both systemic and local immune responses were evaluated.
  
  
  RESULTS
  Significant increase of natural killer cell count in the peripheral blood and cytotoxic T-cell counts in the peri-tumoral and normal mucosa, and a significant decrease of serum immunosuppressive acidic protein level were observed in the PSK group.
  
  
  CONCLUSIONS
  Combined use of PSK with preoperative CRT may improve immune function.
authors.affiliation: Department of Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan. sadahiro@is.icc.u-tokai.ac.jp
authors.forename: Sotaro
authors.initials: S
authors.lastname: Sadahiro
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Suzuki
authors.forename: Yuji
authors.initials: Y
authors.lastname: Maeda
authors.forename: Akira
authors.initials: A
authors.lastname: Tanaka
authors.forename: Akemi
authors.initials: A
authors.lastname: Kamijo
authors.forename: Chieko
authors.initials: C
authors.lastname: Murayama
authors.forename: Yuko
authors.initials: Y
authors.lastname: Nakayama
authors.forename: Takeshi
authors.initials: T
authors.lastname: Akiba
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000276:immunology* / Q000628:therapy*; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007694:Killer Cells, Natural / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D011509:Proteoglycans / Q000627:therapeutic use*; D012004:Rectal Neoplasms / Q000097:blood / Q000276:immunology* / Q000628:therapy*; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology
chemical_list: D007155:Immunologic Factors; D011509:Proteoglycans; C010770:polysaccharide-K