Positive Effects of Oral β-Glucan on Mucositis and Leukopenia in Colorectal Cancer Patients Receiving Adjuvant FOLFOX-4 Combination Chemotherapy

  • Karaca, Halit (Department of Medical Oncology, Erciyes University Medical Faculty) ;
  • Bozkurt, Oktay (Department of Medical Oncology, Erciyes University Medical Faculty) ;
  • Ozaslan, Ersin (Department of Medical Oncology, Erciyes University Medical Faculty) ;
  • Baldane, Suleyman (Department of Internal Medicine, Erciyes University Medical Faculty) ;
  • Berk, Veli (Department of Medical Oncology, Erciyes University Medical Faculty) ;
  • Inanc, Mevlude (Department of Medical Oncology, Erciyes University Medical Faculty) ;
  • Duran, Ayse Ocak (Department of Medical Oncology, Erciyes University Medical Faculty) ;
  • Dikilitas, Mustafa (Department of Medical Oncology, Acibadem Hospital) ;
  • Er, Ozlem (Department of Medical Oncology, Acibadem Hospital) ;
  • Ozkan, Metin (Department of Medical Oncology, Erciyes University Medical Faculty)
  • 발행 : 2014.04.30


The present study aimed to determine the effect of oral ${\beta}$-glucan on mucositis and leukopenia in 62 consecutive patients with colorectal cancer treated with an adjuvant FOLFOX-4 regimen. The patients were retrospectively evaluated in 2 groups: one group received ${\beta}$-glucan and the other did not (control group). Leucocytes, neutrophils, and platelets were evaluated before and 1 week after chemotherapy and oral mucositis and diarrhea were noted. Leucocyte and neutrophil counts after chemotherapy in the ${\beta}$-glucan group were $7,300/mm^3$ and $3,800/mm^3$, respectively, and the reductions, as compared to baseline, were not significant (p=0.673 and 0.784). The median platelet count was $264,000/mm^3$ after chemotherapy in the ${\beta}$-glucan group and the reduction, as compared to baseline, was borderline significant (p=0.048). In the control group, reduction in leucocyte, neutrophil, and platelet counts was statistically significant. Oral mucositis and diarrhea were less common in the ${\beta}$-glucan group. We conclude that ${\beta}$-glucan can be used to reduce the adverse effects of chemotherapy.


  1. Akazawa N, Tagucahi K, Imai A, et al (2010). A case of advanced gastric cancer responding to S-1/paclitaxel/lentinan as neoadjuvant chemoimmunotherapy. Gan To Kagaku Ryoho, 37, 1365-7
  2. Chan GC, Chan WK, Sze DM (2009). The effects of $\beta$-glucan on human immune and cancer cells. J Hematol Oncol, 10, 2-25.
  3. Demir G, Klein HO, Mandel-Molinas N, Tuzuner N (2007). Beta glucan induces proliferation and activation of monocytes in peripheral blood of patients with advanced breast cancer. Int Immunopharmacol, 7, 113-6.
  4. Harada K, Itashiki Y, Takenawa T, Ueyama Y (2010). Effects of lentinan alone and in combination with fluoropyrimidine anticancer agent on growth of human oral squamous cell carcinoma in vitro and in vivo. Int J Oncol, 37, 623-31.
  5. Hazama S, Watanabe S, Ohashi M, et al (2009). Efficacy of orally administered superfine dispersed lentinan (beta-1,3-glucan) for the treatment of advanced colorectal cancer. Anticancer Res, 29, 2611-7.
  6. Inglin S, Amsler S, Arigoni F, et al (2008). Complementary medicine use in oncology patients. Revue Medicale Suisse, 4, 1264-6.
  7. Kataoka H, Shimura T, Mizoshita T, et al (2009). Lentinan with S-1 and paclitaxel for gastric cancer chemotherapy improve patient quality of life. Hepatogastroenterology, 56, 547-50.
  8. Kawaoka T, Yoshino S, Hazama S, Tangoku A, Oka M (2003). Clinical evaluation of intrapleural or peritoneal administration of lentinan and OK-432 for malignant effusion. Gan To Kagaku Ryoho, 30, 1562-5.
  9. Kenji Ina, Ryuichi Furuta, Takae Kataoka, et al (2011). Lentinan prolonged survival in patients with gastric cancer receiving S-1-based chemotherapy. World J Clin Oncol, 2, 339-43
  10. McEachrane-Gross FP, Liebschutz JM, Berlowitz D (2006). Use of selected complementary and alternative medicine (CAM) treatments in veterans with cancer or chronic pain: a crosssectional survey. BMC Complement Altern Med, 6, 6-34.
  11. Miyakoshi H, Aoki T, Mizukoshi M (1984). Acting mechanisms of Lentinan in human--II. Enhancement of non-specific cell-mediated cytotoxicity as an interferon inducer. Int J Immunopharmacol, 6, 373-9.
  12. Mueller CM, Mai PL, Bucher J, et al (2008). Complementary and alternative medicine use among women at increased genetic risk of breast and ovarian cancer. BMC Complement Altern Med, 30, 8, 17.
  13. Nakagawa Y, Yanagawa K, Matsunaga N, Noda S (2010). A case of gastric cancer with para-aortic lymph node metastasis successfully treated with S–1/paclitaxel/lentinan combination therapy. Gan To Kagaku Ryoho, 37, 1131-4.
  14. Nakano H, Namatame K, Nemoto H, et al (1999). A multiinstitutional prospective study of lentinan in advanced gastric cancer patients with unresectable and recurrent diseases: effect on prolongation of survival and improvement of quality of life. Kanagawa Lentinan Research Group. Hepatogastroenterology, 46, 2662-68.
  15. Nazik E, Nazik H, Api M, Kale A, Aksu M (2012). Complementary and alternative medicine use by gynecologic oncology patients in Turkey. Asian Pac J Cancer Prev, 13, 21-5.
  16. Ooi VE Liu F (2000). Immunomodulation and anti-cancer activity of polysaccharide-protein complexes. Curr Med Chem, 7, 715-29.
  17. Papila C, Caner M, Papila I, Yanardag H, Cansiz H (2004). The effect of oral $\beta$-glucan in addition to systemic chemotherapy on leukocyte values and oral mucositis in the patients with head-neck tumors. Int Rev Allergol Clin Immunol, 10, 59-61.
  18. Supoken A, Chaisrisawatsuk T, Chumworathayi B (2009). Proportion of gynecologic cancer patients using complementary and alternative medicine. Asian Pac J Cancer Prev, 10, 779-82.
  19. Torello CO, Souza-Queiroz J, Queiroz ML (2012). $\beta$-1,3-Glucan given orally modulates immunomyelopoietic activity and enhances the resistance of tumour-bearing mice. Clin Exp Pharmacol Physiol, 39, 209-17.
  20. Vannucci L, Krizan J, Sima P, et al (2013).Immunostimulatory properties and antitumor activities of glucans (Review). Int J Oncol, 43, 357-64.
  21. Watanabe T, Shimada R, Matsuyama A, et al (2013). Antitumor activity of the $\beta$-glucan paramylon from Euglena against preneoplastic colonic aberrant crypt foci in mice. Food Funct, 4, 1685-90.
  22. Yang C, Chien LY, Tai CJ (2008). Use of complementary and alternative medicine among patients with cancer receiving outpatient chemotherapy in Taiwan. J Altern Complement Med, 14, 413-16.
  23. Yoshino S, Watanabe S, Imano M, et al (2010). Improvement of QOL and prognosis by treatment of superfine dispersed lentinan in patients with advanced gastric cancer. Hepatogastroenterology, 57, 172–7.
  24. Zhong W, Hansen R, Li B, et al (2009). Effect of yeast derivated beta-glucan in conjuction with bevacizumab for he treatment of human lung adenocarcinoma in subcutaneous and orthotopic xenograft models. J Immunother, 32, 703-12.

피인용 문헌

  1. Effect of Beta Glucan on White Blood Cell Counts and Serum Levels of IL-4 and IL-12 in Women with Breast Cancer Undergoing Chemotherapy: A Randomized Double-Blind Placebo-Controlled Clinical Trial vol.15, pp.14, 2014,
  2. Risk Factors for Chemotherapy-Induced Leukopenia in Patients with Lung Cancer vol.07, pp.03, 2016,
  3. Consumption of β-glucans to spice up T cell treatment of tumors: a review vol.18, pp.10, 2018,
  4. Adjunctive Treatments for the Prevention of Chemotherapy- and Radiotherapy-Induced Mucositis pp.1552-695X, 2018,