BACKGROUND: In the present study, the effect of immunochemotherapy with lentinan compared with that of chemotherapy alone was evaluated in patients with advanced gastric cancer through individual patient data (IPD) meta-analysis. MATERIALS AND METHODS: Based on a computerized and manual search, all eligible centrally randomized controlled trials (RCT) which compared chemotherapy regimens with or without lentinan administration for advanced gastric cancer patients were included. RESULTS: In total, 650 IPD from 5 trials were available. Lentinan significantly prolonged the overall survival (stratified log-rank p=0.011). The overall hazard ratio (HR) was 0.80 (95% confidence interval=0.68-0.95) and there was no heterogeneity between trials. Additionally, lentinan was possibly more effective in patients with lymph-node metastasis than in non-node metastasis patients (P for interaction=0.077). CONCLUSION: The addition of lentinan to standard chemotherapy offers a significant advantage over chemotherapy alone in terms of survival for patients with advanced gastric cancer.

OBJECTIVE: Meta-analysis of systematic review evaluated lentinan (LNT) alone or in combination with other drug treatment of malignant pleural effusion (MPE) the clinical efficacy and safety. METHODS: Pubmed, Cochrane Library, Embase, CBM, CNKI , VIP and Wanfang database system, a comprehensive collection of relevant LNT alone or in combination with other medications MPE controlled clinical studies. RESULTS: The systematic review of 17 randomized controlled trials included a total of 7,978 patients, of which 500 cases LNT group, cis platinum group of 478 cases. Meta analysis showed, LNT group was significantly better than the clinical efficacy of cisplatin group (OR = 3.68,95% CI = 2.75 ~ 4.94; P <0.00001); LNT group after treatment, Karnofsky score increased number of patients cisplatin were significantly more patients (OR = 3.79,95% CI = 2.46 ~ 5.84, P <0.00001), which reduces the number of patients and stable cisplatin group was significantly lower than in patients (OR = 0.41,95% CI = 0.21 ~ 0.78, P = 0.007; OR = 0.37,95% CI = 0.22 ~ 0.60, P <0.0001); LNT group gastrointestinal reactions, and hematologic toxicity was significantly reduced compared with cisplatin group (OR = 0.31,95% CI = 0.21 ~ 0.47, P <0.00001; OR = 0.49,95% CI = 0.28 ~ 0.84, P = 0.01). CONCLUSIONS: available evidence suggests that, LNT monotherapy or in combination with other medications MEP clinical efficacy and safety are excellent on cisplatin alone, can be widely used in clinical treatment of advanced malignant pleural effusion.

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OBJECTIVE: To systematic review and analysis the clinical efficacy and toxicity of lentinan injection combined with chemotherapy in the treatment of nonsmall cell lung cancer (NSCLC). MATERIALS AND METHODS: The databases of PubMed and CNKI were electronic searched with the free text word of lung cancer/NSCLC and lentinan. The prospective clinical study reporting the clinical efficacy and safety of lentinan injection combined with chemotherapy in the treatment of NSCLC were reviewed and included in this meta-analysis. The combined treatment efficacy and toxicity of lentinan injection combined with chemotherapy were pooled by Stata 11.0 software. RESULTS: Twelve clinical studies of lentinan injection combined with chemotherapy in the treatment of NSCLC with 458 controls and 492 NSCLCs patients were finally included in this meta-analysis. The pooled results indicated that the objective response rate was significant improved in the lentinan injection combined chemotherapy group compared with chemotherapy group only (relative risk [RR] = 1.31, 95% confidence interval [CI]: 1.14-1.52). The chemotherapy-related toxicity of III/IV gastrointestinal reaction (RR = 0.54, 95% CI: 0.43-0.68) and III/IV granulocytopenia (RR = 0.65, 95% CI: 0.51-0.70) were significant decreased in the combined group. CONCLUSION: Lentinan injection combined chemotherapy significant increase the objective response rate and decreased the chemotherapy-related toxicity.

INTRODUCTION: Hepatocellular carcinoma (HCC) is one of the most common cancer-related causes of death worldwide and there is a clear need for further treatment options. In this study, we assessed the efficacy of a combination of lentinan (a fungal extract), transcatheter arterial chemoembolisation (TACE) and radiofrequency ablation (RFA) in HCC patients. METHODS: Seventy-eight patients with HCC confirmed by pathology and iconographical checks were used in this study. A total of 136 tumours with a mean diameter of 6.5 cm were detected (standard deviation [SD]+/-0.7). Subjects were divided into four groups, receiving either TACE only, RFA only, RFA and TACE, or the combination group - receiving lentinan, RFA and TACE. RESULTS: The tumour necrosis was significantly higher in the combination group (88.6%), compared to the TACE group (37.5%), the RFA group (47.8%) and the TACE/RFA group (60.3%; P<0.05). The tumour recurrence rate was significantly lower in the combination group (17.8%), compared to the TACE group (45.8%), the RFA group (34.7%) and the TACE/RFA group (29.0%; P<0.05). Finally, mean survival duration was significantly higher in the combination group (28.2 months; P<0.05). CONCLUSION: Combination therapy involving lentinan, RFA and TACE was beneficial in terms of increasing mean survival duration, tumour necrosis and reducing the recurrence rate. Lentinan may therefore be of benefit to HCC patients.

CRD SUMMARY: This review based on individual patient data (650 patients) found a modest increase in overall survival rates in patients with advanced gastric cancer treated when a combination of fluorinated pyrimidines and lentinan was used compared with the chemotherapy alone. The results are likely to be reliable assuming that the small sample size did not limit generalisability.

PURPOSE: This retrospective study evaluated immunity in elderly patients with unresectable gastric cancer receiving S-1/ Lentinan combination chemotherapy. PATIENTS AND METHODS: This study included 10 patients aged≥70 years with unresectable gastric cancer who received S-1/Lentinan combination chemotherapy between October 2008 and December 2012. All patients gave written informed consent. Immune parameters for regulatory T cell(Treg)ratio, prostaglandin E2(PGE2), C3, CH50, and granulocyte/lymphocyte ratio were measured before chemotherapy initiation and at 7 weeks after it. Clinicopathological or immune parameters affecting overall survival(OS)were consequently evaluated. RESULTS: A high Treg ratio(p=0.02) and low PGE2(p=0.05)levels at 7 weeks after chemotherapy and a decrease in the Treg ratio(p=0.02)were found to be significant favorable factors affecting OS. CONCLUSION: The outcome of elderly patients with unresectable gastric cancer receiving S-1/Lentinan combination chemotherapy seemed to be correlated with the change in immunity.

Shiitake dermatitis is a rare cutaneous reaction to lentinan, a polysaccharide component in the cell walls of shiitake mushrooms (Lentinula edodes). Herein, we systematically review the case report and case series English-language literature on shiitake dermatitis, which refers to a total of 50 patients (38 males, 12 females; mean age: 44.58 years). The majority of cases occurred after the consumption of raw mushrooms, whereas 22% of cases were caused by the eating of lightly or undercooked mushrooms. The most common clinical presentations, localized symptoms, and systemic findings include linear flagellated dermatitis (98%), pruritus (78%), and fever, diarrhea, and mucosal ulcers, respectively. The diagnosis of this entity continues to be based on clinical findings as laboratory abnormalities, and the findings of skin biopsies and patch/prick tests are nonspecific and inconsistent. The condition is self-limiting, resolving in approximately 12.5 d without treatment. Based on the included case reports, it appears that medical treatment may slightly shorten the course of disease (to 9-11 d, varying by therapy) but should be considered on an individual patient basis. However, the treatment of symptoms, reassurance, and the avoidance of re-exposure are sufficient treatment recommendations for this condition.

Standardized aqueous mistletoe extracts have been applied to cancer patients for several decades as complementary medicine. A multicentric, randomized, open, prospective clinical trial was conducted in three oncological centers in the People's Republic of China in Bejing, Shenyang and Tianjin. Following the guidelines of "Good Clinical Practice" (GCP) this study was performed to get information on efficacy safety and side-effects of the standardized mistletoe extract (sME). Two hundred and thirty-three patients with breast (n=68), ovarian (n=71) and non-small cell lung cancer (NSCLC; n=94) were enrolled into this study. Two hundred and twenty-four patients fulfilled the requirements for final analysis (n=115 treated with sME HELIXOR A; n=109 comprising the control group being treated with the approved immunomodulating phytopharmacon Lentinan). All patients were provided with standard tumor-destructive treatment schedules and complementarily treated with sME or Lentinan during chemotherapy according to treatment protocol. Biometrically, the patients of the control and sME treatment group were comparable regarding distribution, clinical classification (WHO) and treatment protocols. Analysis was performed according to the "Intention to treat principle". Quality of life (QoL) was significantly (p<0.05) improved for patients who were complementarily treated with sME, as determined by the questionnaires FLIC (Functional Living Index-Cancer), TCM (Traditional Chinese Medicine Index) and the KPI (Karnofsky Performance Index) in comparison to the control group. Additionally, the occurrence of adverse events (AEs) was less frequent in the sME than in the control group (total number of AEs 52 versus 90 and number of serious AEs 5 versus 10 in study and control group, most of them due to chemotherapy). Only one serious AE was allocated to complementary treatment in each group (1 angioedema in sME group). All other side-effects of the sME (7 harmless local inflammatory reactions at subcutaneous injection site, 4 cases with fever) were self-limiting and did not demand therapeutic intervention. This study showed that complementary treatment with sME can beneficially reduce the side-effects of chemotherapy in cancer patients and thus improve quality of life.