肿瘤抗原致敏树突状细胞疫苗联合热疗治疗晚期非小细胞肺癌的临床观察  

Antigen-pulsed dendritic cell vaccine combined with hyperthermia in treatment of advanced non-small cell lung cancer

作　　者：朱利明[1] 张沂平[1] 余新民[1] 邓清华[2] 吴稚冰[3] 马胜林[2] 

机构地区：[1]浙江省肿瘤医院化疗中心,浙江杭州310022 [2]浙江省肿瘤医院放疗科,浙江杭州310022 [3]浙江省肿瘤医院综合治疗科,浙江杭州310022

出　　处：《中国肿瘤生物治疗杂志》2008年第1期66-69,共4页Chinese Journal of Cancer Biotherapy

基　　金：浙江医学高等院校自然科学研究基金资助项目(No2004XZ11)~~

摘　　要：目的：探讨树突状细胞疫苗联合热疗治疗晚期非小细胞肺癌的安全性和临床疗效。方法：14例晚期非小细胞肺癌患者入组，均符合研究的纳入及排除标准，并签署知情同意书；患者单采外周血单核细胞体外培育成树突状细胞，将抗原致敏制备成的树突状细胞疫苗回输患者，回输前1d使用NRL-001型内生场热疗系统对患者肿瘤局部进行射频加温，疫苗回输3次为1个周期。结果：14例患者共接受16周期联合治疗。不良反应主要表现为发热、寒战、肌肉酸痛、一过性全身无力、皮肤瘙痒、胸闷、皮肤局部红斑和水疱。全组治疗后稳定7例，进展7例，临床获益率50％；患者中位达进展时间（median time to progression，mTTP）为2.7个月，生存时间为2.5-29.3个月，中位生存时间为4.9个月，1年生存率（3／14）为21．4％。结论：肿瘤抗原致敏树突状细胞疫苗联合热疗治疗晚期非小细胞肺癌总体耐受性良好，亦可见临床获益，其临床价值有待进一步探讨。Objective： To evaluate the safety and clinical efficacy of antigen-pulsed dendritic cell （APDC） vaccine combined hyperthermia in treating advanced non-small cell lung cancer （ NSCLC ）. Methods： Fourteen patients with advanced NSCLC were enrolled in this study. All patients met the selecting standard and signed informed consent. Human dendritic cells were derived from peripheral blood monocytes by co-culturing them with granulocyte macrophage-colony stimulating factor and interleukin-4. DCs vaccine was prepared from antigen pulsed immature dendritic cells in vitro. The vaccine therapy was given once every week following local hyperthermia by NRL-001 Double RF Tumor Hyperthermia system （39.5℃-41℃ for 60 - 120 min）. Every three-week was defined as a treatment cycle. Results： All patients re- ceived 16 cycles of combined treatment. The main adverse effect included fever, chill, myalgia, transient fatigue, itching, chest distress, local rashes, and blister. Seven of 14 patients had stable condition after treatment and another seven had a progressing condition, with a clinical beneficial rate of 50%. Median time to progress was 2.7 months in the patients and the overall survival period was 2.5 to 29.3 months, with the median survival time being 4.9 months ; the one year survival rate was 21.4% in our group. Conclusion： The results suggest that combination of APDC vaccine therapy and local hyperthermia is well tolerated by NSCLC patients and is clinically beneficial to the patients; the clinical value of this therapy needs to be further studied.

关 键 词：树突状细胞 疫苗 热疗 非小细胞肺癌 免疫治疗 

分 类 号：R734.2[医药卫生—肿瘤] R730.54[医药卫生—临床医学]