自体CIK细胞联合化疗一线维持治疗非小细胞肺癌的疗效与安全性  

Curative Effect and Safety of Autologous Cytokine-induced Killer Cells Combined with Chemotherapy in the First Line Maintenance Treatment of Non-small Cell Lung Cancer

作　　者：丁震宇[1] 韩雅玲[2] 朴瑛[1] 张冠中[1] 郑振东[1] 于卉影[3] 孙英慧[3] 马东初[3] 谢晓冬[1] 

机构地区：[1]沈阳军区总医院全军肿瘤诊治中心肿瘤科,沈阳110840 [2]沈阳军区总医院全军心血管病研究所,沈阳110840 [3]沈阳军区总医院全军肿瘤诊治中心医学实验科,沈阳110840

出　　处：《解放军医药杂志》2015年第1期31-36,40,共7页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：科技部重大新药创制创新药物研究开发技术平台建设(2012ZX0903016-002);辽宁省科技攻关计划课题(2012225019)

摘　　要：目的探讨自体细胞因子诱导的杀伤细胞(CIK)在晚期非小细胞肺癌(NSCLC)患者维持治疗中的应用前景及意义。方法选取2011年3月—2013年9月收治的确诊的ⅢB或Ⅳ期NSCLC患者80例,随机分为联合组与对照组,每组40例。对照组均采用单药多西他赛或培美曲塞方案一线维持治疗,联合组先行单药培美曲塞或多西他赛一线维持化疗,间隔半个月后再行自体CIK细胞免疫治疗。对两组进行生存分析、评价近期疗效、检测外周血T淋巴细胞表型、卡氏功能状态量表(KPS)评分及生活质量测评、监测毒性反应。结果两组间无进展生存期无差异(P>0.05);联合组客观缓解率及疾病控制率均高于对照组(P<0.05);联合组治疗后T淋巴细胞亚群水平与本组治疗前及对照组治疗后比较均有统计学差异(P<0.05);联合组KPS评分提高率显著优于对照组(P<0.05);治疗后联合组疲倦、气促、失眠、食欲下降、恶心呕吐等症状改善,躯体功能及总生活质量评分均显著优于对照组及本组治疗前(P<0.05);联合组中性粒细胞降低发生率、胃肠道反应发生率均明显低于对照组(P<0.05)。结论自体CIK细胞联合化疗与单纯化疗相比,可显著提高接受一线维持治疗的晚期NSCLC患者的免疫功能、改善生活质量、降低毒性反应、提高化疗耐受性、获得更高的总体有效率。Objective To evaluate the application prospects and significance of autologous cytokine-induced killer（ CIK） cells combined with maintenance chemotherapy for patients with non-small cell lung cancer（ NSCLC）.Methods A total of 80 NSCLC patients with stage ⅢB or Ⅳ admitted during March 2011 and September 2013 were randomly divided into combination group（ n = 40） and control group（ n = 40）. The control group received the first line maintenance treatment using only Docetaxel or Pemetrexed,while the combination group was treated with autologous CIK cells immunotherapy based on the treatment of the control group. The survival analysis,short-term curative effect evaluation,detection of T-lymphocyte phenotypes,evaluation of Kamofsky Performance Status（ KPS） score,assessment of quality of life and detection of toxic reaction were performed in the two groups. Results There was no significant difference in progression-free survival（ PFS） rate between the two groups（ P〉0. 05）; but objective response rate（ ORR） and disease control rate（ DCR） of combination group were significantly higher than those in control group（ P〈0. 05）; the differences in T-lymphocyte immune activity after the treatment in combination group were statistically significant compared with those before the treatment in the same group and after treatment in the control group（ P〈0. 05）; KPS score in combination group was significantly improved compared with that in control group（ P〈0. 05）; the symptomatic improvements in terms of fatigue,short breath,sleeplessness,anorexia,nausea and vomiting,scores of physical function and quality of life after the treatment in combination group were significantly superior than those before the treatment in the same group and after treatment in the control group（ P〈0. 05）; the incidence rates of neutrophilic granulocyte reduction and gastrointestinal reaction in combination group were significantly lower than those in control group（ P〈0. 05）.Conclusion Co

关 键 词：癌 非小细胞肺 细胞因子诱导杀伤细胞 抗肿瘤联合化疗方案 维持化疗 生活质量 

分 类 号：R730.26[医药卫生—肿瘤]