DC-CIK细胞联合EGFR-TKI治疗35例老年晚期EGFR突变肺癌的效果  

Efficacy of DC-CIK cells combined with EGFR-TKI for 35 elderly patients with advanced EGFR-mutant lung cancer

作　　者：王福立[1] 孙银萍[1] 秦杰[2] 荣建胜 WANG Fuli;SUN Yinping;QIN Jie;RONG Jiansheng(Department of Oncology,Zibo Central Hospital,Zibo 255000,Shandong,China;Department of Oncology,Gaoqing People's Hospital,Gaoqing 256300,Shandong,China;Department of Pathology,Zibo Central Hospital,Zibo 255000,Shandong,China)

机构地区：[1]淄博市中心医院肿瘤科,山东淄博255000 [2]高青县人民医院肿瘤科,山东高青256300 [3]淄博市中心医院病理科,山东淄博255000

出　　处：《山东大学学报（医学版）》2022年第7期110-117,共8页Journal of Shandong University:Health Sciences

基　　金：山东省医药卫生科技发展计划项目(2017WS561);山东省淄博市科学技术发展计划项目(2017kj010004)

摘　　要：目的探讨树突状细胞-细胞因子诱导的杀伤细胞(DC-CIK)联合表皮生长因子受体酪氨酸激酶抑制剂(EGRF-TKI)治疗老年晚期表皮生长因子受体(EGFR)突变肺癌的临床疗效。方法将70例Ⅳ期EGFR突变肺癌患者分为治疗组和对照组。治疗组35例,给予DC-CIK细胞治疗联合吉非替尼或厄洛替尼靶向治疗;对照组35例,给予吉非替尼或厄洛替尼靶向治疗。结果治疗组的疾病控制率(DCR)为88.6%,高于对照组的68.6%(P=0.041),治疗组生活质量评分改善率为71.4%,高于对照组的45.7%(P=0.029),差异均有统计学意义。治疗组和对照组的1年、2年和3年总生存(OS)率分别为62.9%vs 57.1%、37.1%vs 31.4%和8.6%vs 2.9%,两组比较差异无统计学意义(P=0.217)。治疗组和对照组的1年、2年和3年无进展生存(PFS)率分别为57.1%vs 31.4%、20.0%vs 5.7%和2.9%vs 0%,两组差异有统计学意义(P=0.005)。多因素分析显示,腺癌(HR=0.178,95%CI:0.061~0.523)及高分化(HR=0.058,95%CI:0.015~0.228)患者OS更长,腺癌(HR=0.271,95%CI:0.094~0.777)及高分化(HR=0.089,95%CI:0.029~0.272)患者PFS也更长。治疗组和对照组不良反应发生率差异无统计学意义(P>0.05)。结论DC-CIK细胞联合EGRF-TKI可以提高晚期老年EGFR突变肺癌患者的疾病控制率和生活质量,延长患者的PFS。Objective To investigate the clinical efficacy of dendritic cells-cytokine-induced killer cells(DC-CIK cells)combined with epidermal growth factor receptor-tyrosine kinase inhibitor(EGRF-TKI)for elderly patients with advanced EGFR-mutant lung cancer.Methods A total of 70 patients with stage IV lung cancer were divided into treatment group and control group.In the treatment group,35 patients received DC-CIK cell therapy combined with gefitinib or erlotinib targeted therapy.In the control group,35 patients received gefitinib or erlotinib targeted therapy.Results The disease control rate(DCR)of the treatment group and control group were 88.6%and 68.6%,respectively,with significant difference(P=0.041).The improvement rate of patients?quality of life was significantly higher in the treatment group than in the control group(71.4%vs 45.7%,P=0.029).The 1-year,2-year,and 3-year overall survival(OS)rates of the treatment group and control group were 62.9%vs 57.1%,37.1%vs 31.4%,and 8.6%vs 2.9%,respectively,with no significant differences(P=0.217).The 1-year,2-year,and 3-year progression-free survival(PFS)rates of the treatment group and control group were 57.1%vs 31.4%,20.0%vs 5.7%,and 2.9%vs 0,respectively,with significant differences(P=0.005).Multivariate analysis showed that patients with adenocarcinoma(HR=0.178,95%CI:0.061-0.523)and well-differentiated cancer(HR=0.058,95%CI:0.015-0.228)had longer OS,and patients with adenocarcinoma(HR=0.271,95%CI:0.094-0.777)and well-differentiated cancer(HR=0.089,95%CI:0.029-0.272)also had longer PFS.There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion DC-CIK cells combined with EGRF-TKI can improve the disease control rate and patients?quality of life,and prolong the PFS in elderly patients with advanced EGFR-mutant lung cancer.

关 键 词：肺癌 靶向治疗 树突状细胞 细胞因子诱导的杀伤细胞 吉非替尼 厄洛替尼 

分 类 号：R734.2[医药卫生—肿瘤]