香菇多糖联合化疗治疗晚期非小细胞肺癌

Efficacy of Lentinan combined with chemotherapy in advanced non-small cell lung cancer

背景与目的 香菇多糖作为一种生物免疫调节剂日益受到药学界与临床的广泛重视，目前中国和日本都将其作为一种抗肿瘤辅助药品广泛应用。本研究旨在观察香菇多糖联合化疗治疗Ⅲ、Ⅳ期非小细胞肺癌的治疗效果。方法 81例Ⅲ、Ⅳ期非小细胞肺癌患者随机分为A、B两组，A组（42例）采用香菇多糖加化疗，B组（39例）采用单纯化疗。两组患者在治疗前后测定外周血T淋巴细胞亚群（CD3、CD4、CD4／CDR）和NK细胞活性，并以正常人（30例）作为对照，对患者疗效、免疫功能、生活质量及不良反应进行评价。结果 治疗后A、B两组的有效率分别为50％和33％（P＜0．05）；A组的T淋巴细胞亚群和NK细胞活性明显高于治疗前（P＜0．01），CDR明显低于治疗前（P＜0．05），而B组无明显变化（P〉0．05）；A组的Karnofsky评分上升率（52％）高于B组（23％）（P〈0．01）；B组的Ⅱ～Ⅳ度白细胞减少及恶心呕吐反应发生率（分别为51和44例次）高于A组（分别为39和24例次）（P＜0．05）。结论香菇多糖联合化疗治疗Ⅲ、Ⅳ期非小细胞肺癌的疗效优于单纯化疗。

Background and objective Lentinus edodes polysaccharide （Lentinan） has attracted great attention from both pharmacologists and clinicians as a biological response modifier, and is widely used as an anti-tumor agent in both China and Japan. The aim of this study is to observe the efficacy of Lentinan combined with chemotherapy io stage [Ⅲ-Ⅳ non-small cell lung cancer （NSCLC）. Methods Eighty-one patients with stage Ⅲ--ⅣNSCLC were randomly divided into two groups： ①Lentinan ＋ chemotherapy group （group A, 42 cases）; ②Simple chemotherapy group （group B, 39 cases）. The peripheral blood T lymphocyte subsets （CD3, CD4, CD4/CD8） and natural killer （NK） cell activity of patients in both groups were measured before and after treatment, while compared with healthy control （30 cases）. The immune functions, the effect of treatment, quality of life, and adverse reactions were observed. Results After treatment the objective response rate （CRWPR） was 50% in group A, compared to 33% in group B （P〈0. 05）. The blood T cell levels （CD3, CD4 , CD4/CD8 ） and NK cell activity in group A increased （P〈0.01）, CD8 reduced （P〈0. 05）, but in group B the value had no obvious change （P〉0.05）. Quality of life in group A was higher than that in group B （P〉0. 01）. The incidence of grade Ⅱ-Ⅳleukopenia, nausea and vomiting in group B was much higher than those in group A （P〈0.05）. Conclusion The therapeutic effect of Lentinan combined with chemotherapy is better than that of chemotherapy alone.