紫杉醇顺铂方案联合自体CIK细胞输注治疗晚期食道癌的临床分析  

A clinical research of paclitaxel,Cisplatin combined with autologous CIK cell infusion in the treatment of advanced esophageal cancer

作　　者：张彤[1] 王佩[1] 张振海[1] 

机构地区：[1]河南省新乡市中心医院肿瘤内科,新乡453000

出　　处：《中国免疫学杂志》2012年第7期652-656,共5页Chinese Journal of Immunology

摘　　要：目的:晚期食道癌的的治疗以化疗为主,紫杉醇顺铂方案治疗晚期食道癌因疗效确定,在临床应用日益推广。自体CIK细胞治疗晚期恶性肿瘤能起到延缓或阻止肿瘤的转移与复发,并可提高晚期食道癌患者的细胞免疫功能及改善生活质量等综合作用。本组应用紫杉醇顺铂方案联合自体CIK细胞输注治疗晚期食道癌患者,旨在探讨采用自体CIK细胞输注同步化疗的综合治疗方法,是否能提高晚期食道癌的临床疗效。方法:本科自2008年1月至2010年1月共入选59例患者。均为Ⅳ期食道癌病人。化疗方案剂量及方法设定:自体CIK治疗操作流程:采血前一天需对患者进行血常规检测,对于白细胞数低于8×109L-1的患者应于采血前24小时注射1～2支集落刺激因子。采血前急查血常规,确认患者白细胞数达到或高于8×109L-1时方可采血,采集患者静脉血50 ml。培养至14天左右细胞成熟,经检验科和实验室测量CIK细胞数量达1×109～11L-1时,对细胞培养物进行无菌检测,当检验科和实验室自身均检测无菌后,安排进行回输。自体CIK细胞输注+紫杉醇顺铂方案治疗组:Cik采血,d1,紫杉醇PTX 175 mg/m2,d2,顺铂DDP 20 mg/m2,静滴d3-7,紫杉醇使用前严格按照说明书进行预处理。CIK回输:d14。21天为1个周期,2个周期后评价疗效。结果:全组59例患者总有效率为32.2%(19/59),其中完全缓解率为1.7%(1/59),部分缓解率为30.5%(18/59),稳定52.5%(31/59),进展15.2%(9/59)。中位进展时间7.6个月,中位生存时间11.7个月。主要毒性反应为外周血细胞下降、脱发及外周神经毒性。结论:应用紫杉醇顺铂方案联合自体CIK细胞输注治疗Ⅳ期食道癌,疗效突出,毒性反应轻微,治疗顺应性好,提高了患者的生存质量,值得进一步推广。Objective：The primary treatment of advanced esophageal cancer is chemotherapy. In recent years, paclitaxel, Cisplatin for the treatment of advanced esophageal cancer have determine efficacy in clinical application of increasingly promotion. Autologous CIK cell treatment of advanced cancer can play slow or prevent tumor metastasis and recurrence in patients with advanced esophageal cancer and improve immune function and quality of life. The aim of this study was to evaluate the efficacy and safety of combination therapy with paclitaxel, Cisplatin combined with autologous CIK cell infusion in advanced esophageal cancer patients. Methods： Undergraduate from January 2008 to January 2010,59 advanced esophageal cancer patients were enrolled. Chemotherapy dose and method of setting ： Autologous CIK treatment operation process ： The day before the Blood collection of patients required routine blood test. For white blood cell count less than 8 × 10^9 L-1 patients should be injected 1 to 2 colony-stimulating factor in twenty-four hours before the Blood collection. Emergency check blood before blood sampling to confirm the number of white blood cells in patients at or above 8 × 10^9 L-1 before Blood collection. Cultured cells mature to 14 days, the number of up to 1 × 10^9-11 L-1. Arrangement of cell cultures for sterility testing, when the third party inspection and laboratory testing itself were sterile, Start reinfusion. Autologous CIK cell infusion ＋ paelitaxel, Cisplatin in the treatment group ： CIK Blood collection/ dl ; paclitaxel （ PTX ） 175 mg/m2 d2, Cisplatin （DDP） 20 mg/m2, d3-7, strict accordance with the instructions before using paclitaxel as pretreatment. 21 days for one cycle, two cycles were evaluated. Results： The patients received a median of 4 cycles of treatment （range, 2-6 cycles ）. 1 of the 59 patients （1.7%） achieved complete response, and 18 of the 59 patients （30.5%） achieved partial responses. The disease control rate （partial response ＋ stable disease） w

关 键 词：晚期食道癌 紫衫醇 顺铂 细胞因子诱导的杀伤细胞 免疫治疗 综合治疗 

分 类 号：R735.1[医药卫生—肿瘤]