化疗联合腹腔灌注细胞因子诱导的杀伤细胞治疗胃癌腹水  

A pilot study of chemotherapy combined with intraperitoneal perfusion of cytokine-induced killer cells for advanced gastric cancer patients with ascites

作　　者：王志明[1] 庄荣源[1] 陈勇[1] 冯艺[1] 李倩[1] 刘天舒[1] 

机构地区：[1]复旦大学附属中山医院肿瘤内科,上海200052

出　　处：《中华胃肠外科杂志》2013年第1期28-31,共4页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的评价化疗联合腹腔灌注细胞因子诱导的杀伤细胞（CIK）过继免疫治疗胃癌腹水的疗效和安全性。方法将2008年1月至2010年12月间复旦大学附属中山医院收治的伴有明显腹水的42例晚期胃癌患者，根据患者个人意愿分为单纯化疗组（22例，希罗达加奥沙利铂的XELOX方案）和联合治疗组（20例，XELOX方案化疗联合腹腔灌注CIK）。比较两组患者临床疗效、不良反应及免疫功能。结果与单纯化疗组相比，治疗后联合治疗组患者Karnofsky评分明显更高（78．0±9．8比70．0±8．9，P=0．009），两个周期内的腹水引流量明显减少[（4500±1218）ml比（5527±1460）ml，P=0．018]，中位疾病进展时间延长（4．0个月比2．5个月，P=0．006），中位总生存时间延长（11．0个月比6．0个月，P=0．001），CD4^＋／CD8^＋比值升高（1．34±0．36比0．96±0．26，P=0．001），但疾病反应率（35．0％比22．7％，P=0．499）和疾病控制率（75．0％比54．5％。P=0．209）均未见明显增高。两组患者治疗过程均未见明显不良反应。结论与单纯化疗相比,化疗联合CIK免疫治疗对胃癌腹水患者疗效更好,不仅可延长生存期,提高免疫功能,而且具有较好的安全性。Objective To investigate the efficacy and safety of chemotherapy combined with intraperitoneal perfusion of cytokine-induced killer （CIK） cells for advanced gastric cancer patients with ascites, Methods From January 2008 to December 2010, 42 advanced gastric cancer patients with ascites in Zhongshan Hospital of Fudan University were enrolled in the study. According to personal choice, patients were divided into 2 groups： XELOX chemotherapy alone（Capecitabine and Oxaliplatin） was applied in 22 patients （chemotherapy group） and XELOX combined with intraperitoneal perfusion of CIK cells in 20 patients （combination group）. The efficacy, safety, and immunological function, including the time to progression （TIP）, overall survival （OS）, Karnofsky performance status （KPS） score, immunity index （CD4^＋/CD8^＋ ratio）, volume of peritoneal fluid, were compared between two groups. Results Compared with the chemotherapy group after treatment, the combination group had a higher KPS score （78.0±9.8 vs. 70.0±8.9,P=0.009）, less volume of 2-cycle peritoneal fluid drainage [ （4500±1218） ml vs. （5527±1460） ml, P=0.018 ], longer median TIP （4.0 vs. 2.5 months, P=0.001） and OS （11.0 vs. 6.0 months, P=0.006）, higher ratio of CD4＋/CDS＋ （1.34±0.36 vs. 0.96±0.26,P=0.001）. While no significant significances were found between the two groups in disease response rate（35.0% vs. 22.7%,P=0.499） and disease control rate（75.0% vs. 54.5%, P=0.209）. There were no serious adverse reactions in the combination group. Conclusions As compared with XELOX chemotherapy alone, the combination immunological treatment of XELOX chemotherapy and intraperitoneal perfusion of CIK cells possesses better efficacy for the advanced gastric cancer patients with ascites, which can prolong the survival and enhance the immunological function with favorable safety.

关 键 词：胃肿瘤 恶性腹水 化学治疗 免疫治疗 细胞因子诱导的杀伤细胞 

分 类 号：R735.2[医药卫生—肿瘤]