DCs-CIK细胞免疫治疗联合化疗对晚期非小细胞肺癌疗效及安全性的影响  

Efficacy of DCs-CIK immunotherapy combined with chemotherapy in patients with advanced non-small cell lung cancer

作　　者：张曼[1,2] 杨涛[1] 石洋[1] 张文军[1] 李启英[1] 唐显军[1] 黄德鸿[1] 闫国和 杨威 吴仙宇 王宏宇 项颖[1] 

机构地区：[1]重庆市肿瘤研究所血液肿瘤/生物治疗科,重庆400030 [2]广西医科大学研究生院,广西南宁530000 [3]上海柯莱逊生物技术有限公司,上海201201

出　　处：《肿瘤》2014年第4期361-365,共5页Tumor

基　　金：重庆市卫生局医学科研项目(编号:2010-2-301)

摘　　要：目的:探讨树突状细胞(dendritic cells,DCs)-细胞因子诱导的杀伤(cytokine induced killer,CIK)细胞免疫治疗联合化疗对晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)疗效及安全性的影响。方法:将272例晚期NSCLC患者随机分为治疗组(化疗联合DCs-CIK细胞免疫治疗组)和对照组(单纯化疗组)。比较2组治疗后的近期疗效,及治疗前后患者免疫功能和生活质量的变化,并分析DCs-CIK细胞免疫治疗的影响因素,观察其不良反应。结果:近期疗效分析结果显示,治疗组和对照组有效率分别为49.26%和37.50%(P>0.05),疾病控制率为68.38%和54.41%(P<0.05);2组患者治疗前后外周血中表面抗原CD3+、CD8+和自然杀伤细胞所占的比值,差异均有统计学意义(P<0.05);患者年龄、肿瘤分期和Karnofsky体能状况(Karnofsky performance status,KPS)评分是DCs-CIK细胞免疫治疗疗效的影响因素;治疗组患者生活质量优于对照组(P<0.05);行DCs-CIK细胞免疫治疗的患者中仅有15例患者出现低热,未见其他的不良反应。结论:DCs-CIK细胞免疫治疗联合化疗可以提高晚期NSCLC的疾病控制率,改善患者的免疫功能和生活质量;患者的年龄、KPS评分及肿瘤分期可影响其疗效。Objective： To investigate the efficacy and safety of dendritic cells （DCs）-cytokine-induced killer （CIK） immunotherapy combined with chemotherapy in patients with advanced non-small cell lung cancer （NSCLC）. Methods： Two hundred seventy-two patients with advanced NSCLC were randomly divided into two groups： study group （n = 136, treated with DCs-CIK immunotherapy combined with chemotherapy） and control group （n = 136, treated with chemotherapy alone）. The short-term response was compared between the two groups. The changes of immune function and quality of life before and after treatment in the two groups were compared. The potential efficacy-related factors of DCs-CIK immunotherapy were analyzed, and the adverse reactions were observed to assess its safety. Results： The response rates of study group and the control group were 49.26% and 37.50%, respectively （P 〉 0.05）, and the disease control rates were 68.38% and 54.41%, respectively （P 〈 0.05）. The ratios of CD3^＋, CD8^＋ and natural killer （NK） cells in peripheral blood before and after treatment in the two groups had a statistically significant change （P 〈 0.05）. The age, clinical stage and Karnofsky performance status （KPS） score were determined as efficacy-related factors of DCs-CIK immunotherapy. The quality of life was better in the study group than that in the control group （P 〈 0.05）. Only 15 patients in the study group got a low-grade fever after immunotherapy, and no other serious toxicities were found. Conclusion： DCs-CIK immunotherapy combined with chemotherapy can enhance the disease control rate of patients with advanced NSCLC, and improve the immune function and the quality of life without any serious side effects. The age, KPS score and clinical stage may affect the efficacy of DCs-CIK immunotherapy.

关 键 词：癌 非小细胞肺 免疫疗法 树突细胞 杀伤细胞 

分 类 号：R734.2[医药卫生—肿瘤]