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. 2025 Jan-Dec:24:15347354251353499.
doi: 10.1177/15347354251353499. Epub 2025 Jul 1.

Perioperative Clinical Usage of Phellinus Linteus as a Nutraceutical for Non-FOLFIRINOX-Based Postoperative Adjuvant Chemotherapy for Resected Pancreatic Cancer: A Retrospective Cohort Study

Juwan Kim  1   2 , Seung Soo Hong  1   2 , Sung Hyun Kim  1   2 , Ho Kyoung Hwang  1   2 , Chang Moo Kang  1   2
Affiliations

Perioperative Clinical Usage of Phellinus Linteus as a Nutraceutical for Non-FOLFIRINOX-Based Postoperative Adjuvant Chemotherapy for Resected Pancreatic Cancer: A Retrospective Cohort Study

Juwan Kim et al. Integr Cancer Ther. 2025 Jan-Dec.

Abstract

Introduction: Most patients with pancreatic cancer experience systemic recurrence within 1 to 2 years after radical pancreatectomy. Phellinus linteus (PL) has demonstrated anti-inflammatory, antioxidant, and anti-cancer properties, suggesting potential as an adjunct to cancer therapy. This study aimed to evaluate the long-term oncological impact of perioperative PL in resected pancreatic cancer.

Method: This retrospective cohort study included 407 patients who underwent curative resection and adjuvant chemotherapy for pancreatic cancer at Severance Hospital (2012-2022). Among them, 103 patients who began PL postoperatively and continued throughout treatment were assigned to the PL group; 304 patients without PL intake comprised the control group.

Results: The mean overall survival (OS) was significantly longer in the PL group (47.0 months; 95% CI: 42.8-51.1) than in the control group (35.0 months; 95% CI: 30.3-39.7; P < .001). Recurrence-free survival (RFS) showed a borderline improvement (P = .053). PL use was marginally associated with improved OS in multivariate analysis (HR: 0.614; 95% CI: 0.376-1.002; P = .051). Subgroup analysis showed no significant OS or RFS benefit with PL in patients receiving FOLFIRINOX. However, among patients treated with non-FOLFIRINOX regimens, PL use led to significantly better OS (43.9 months vs 35.0 months; P = .021), though RFS remained similar. Notably, the OS of the non-FOLFIRINOX + PL group was comparable to that of the FOLFIRINOX group (P = .332) and superior to the non-FOLFIRINOX control group (P = .021).

Conclusion: PL may enhance survival in resected pancreatic cancer, particularly in patients receiving non-FOLFIRINOX chemotherapy, supporting its role as a potential adjunct when FOLFIRINOX is not feasible.

Keywords: adjuvant; chemotherapy; nutriceuticals; pancreatectomy; pancreatic cancer; phellinus linteus extract.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow chart of patients who received adjuvant chemotherapy after pancreatic resection, showing the inclusion of patients in the study.
Figure 2.
Figure 2.
Kaplan-Meier curves for (A) overall survival and (B) recurrence-free survival, comparing the Phellinus linteus (PL) group and the control (C) group in the entire patient cohort; (C) overall survival and (D) recurrence-free survival among patients who received FOLFIRINOX as adjuvant chemotherapy, comparing the PL group and the C group; (E) overall survival and (F) recurrence-free survival among patients who received other regimens as adjuvant chemotherapy, comparing the PL group and the C group; and (G) overall survival among patients receiving FOLFIRINOX, non-FOLFIRINOX + PL, and non-FOLFIRINOX + no PL.
Figure 3.
Figure 3.
Violin plot of duration of PL prescription in patients who received adjuvant chemotherapy after pancreatic resection.
See this image and copyright information in PMC

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