吉非替尼联合自体DC/CIK细胞治疗对晚期非小细胞肺癌临床研究  

Clinical Research on Gefitinib Combined with Autologous DC/CIK Cells in Treatment of Advanced Non-small Cell Lung Cancer

作　　者：琚芳芳 李宝平[1] 张雷[1] 薛利利[1] 

机构地区：[1]山西医科大学第二医院肿瘤生物治疗科,山西太原030001

出　　处：《中外医疗》2016年第14期61-63,共3页China & Foreign Medical Treatment

摘　　要：目的探讨靶向治疗吉非替尼联合自体树突状细胞（DC）/细胞因子诱导的杀伤细胞（CIK）细胞回输治疗晚期非小细胞肺癌（NSCLC）患者的TGF-β1、免疫功能、安全性及疗效的影响。方法随机选取2013年7月—2015年1月于该院接受治疗的100例晚期非小细胞肺癌患者,采用随机数字表法随机分为治疗组和对照组各50例。对照组单纯采用口服吉非替尼250 mg/d靶向治疗,治疗组在此基础上给予至少3次DC/CIK细胞输注。随访时间为12个月,对比观察两组以下指标：血清TGF-β1、外周血淋巴细胞表型、不良反应、总生存期（OS）和中位生存期（m OS）。结果血清TGF-β1：两组治疗后血清TGF-β1水平均较治疗前下降（P〈0.05）,治疗组下降较对照组明显（P〈0.05）。外周血淋巴细胞表型：经过治疗,治疗组外周血CD 3＋、CD 4＋、CD 8＋和CD 4＋/CD 8＋对对照组相较有明显差异,两组差异有统计学意义（P〈0.05）。不良反应：治疗组接受DC和CIK自体细胞输注后出现发热7例,经相应处理后缓解。两组皮疹和腹泻发生率比较差异有统计学意义（P〈0.05）。治疗组OS为9.1~18.1（12.1±3.4）个月,m OS为11.9个月,对照组分别为7.4~11.5（9.6±1.2）和9.5个月,两组相较差异有统计学意义（P〈0.05）。结论在吉非替尼靶向治疗基础上联合自体DC/CIK细胞回输治疗晚期NSCLC,可以减轻不良反应,改善免疫功能,延长患者生存期,并具有较好的安全性。Objective To discuss the effect of molecular targeted therapy of gefitinib combined with autologous dendritic cells /cytokine induced kill cell adoptive therapy for patients with advanced non-small cell lung cancer on their TGF-β1,immunologic function and safety. Methods 100 cases of patients with advanced non-small cell lung cancer treated in our hospital from July 2013 to January 2015 were selected and randomly divided into two groups with 50 cases in each, the control group received molecular targeted therapy of oral administration of 250 mg/d gefitinib, the treatment group were given DC/CIK cell infusion at least 3 times on this basis, and the follow-up time was 12 months, and the serum TGF-β1,peripheral blood lymphocyte phenotype, adverse reaction, overall survival and median survival time of the two groups were compared and observed. Results The serum TGF-β1levels after treatment of the two groups decreased compared with those before treatment（P〈0.05）, and the decrease of the treatment group was more obvious than that of the control group（P〈0.05）,after treatment, there were obvious differences in the peripheral blood CD 3＋, CD 4＋, CD 8＋ and CD 4＋/ CD 8＋ between the two groups with statistical significance（P〈0.05）. Conclusion After autologous DC/CIK cell infusion, the treatment group relived after the corresponding treatment, and the differences in the incidence rates of rash and diarrhea between the two groups had statistical significance by comparison（P〈0.05）, and the differences in the OS and m OS between the treatment group and the control group had statistical significance [9.1-18.1（12.1 ± 3.4）, 11.9 months, vs 7.4-11.5（9.6 ±1.2）, 9.5months]（P〈0.05）. Molecular targeted therapy of gefitinib combined with autologous DC/CIK cell infusion in treatment of advanced non-small cell lung cancer can relieve the adverse reactions, improve the immunologic function, prolong the survival time of patients and has good safety.

关 键 词：非小细胞肺癌 吉非替尼 树突状细胞 细胞因子诱导杀伤细胞 

分 类 号：R5[医药卫生—内科学]