地塞米松在免疫细胞治疗恶性肿瘤中的作用  

Effects of Dexamethasone in Immunotherapy with Dendritic Cells and Cytokine-induced Killer Cells Therapy for Cancer

作　　者：朱慧[1] 蔡玉梅[1] 张天宇[1] 颜立志[1] 李敬[1] 庞雁[1] 李佳丽[1] 

机构地区：[1]天津市人民医院肿瘤科,天津300121

出　　处：《中国中西医结合外科杂志》2016年第5期431-435,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：天津市科技计划项目(12ZCDZSY17100)

摘　　要：目的:确定树突状细胞和细胞因子诱导的杀伤细胞免疫治疗恶性肿瘤中地塞米松对发热和过敏副作用的预防作用及其对免疫杀伤作用的影响。方法:443例恶性肿瘤患者,根据回输之前是否接收地塞米松治疗回顾性分为两组:A组127例接受地塞米松治疗,B组316例未接受地塞米松治疗。在当天采集外周血单个核细胞以制备DC和CIK细胞,1×107DC分别在第8、15、22 d静脉回输,在第29、36、43 d皮内回输;1×109CIK细胞分别在第11、12、13、14 d静脉回输。结果:A组皮疹发生率4.2%,B组为1.0%,两组间无统计学差异(P=0.088);A组高热和中热发生率分别为14.2%和25.8%,B组分别为6.7%和13.4%,B组显著低于A组(P=0.016和P=0.003),总发热率B组显著低于A组(P=0.000);A组DTH阳性率66.9%,B组为67.1%,两组间无统计学差异(P=0.974);QOL改善A组为54.3%,B组为56.0%,两组间无统计学差异(P=0.772);COX回归分析亦显示地塞米松对生存期无影响(P=0.491)。结论:在恶性肿瘤的DC-CIK免疫治疗中,DC和CIK细胞回输术前预防性给予地塞米松可能是一种有效的方法。Objective To determine the effects of premedication with dexamethasone on fever, skin rash,and immune response in immunotherapy with dendritic cells and cytokine-induced killer cells therapy for cancer.Methods There were 127 cases in group A and 316 cases in group B, according to the premedication received before reinfusion. Peripheral blood monocytes were collected on day 0, and DCs and CIK cells were prepared. 1×10^7DCs were reinfused intravenously on days 8, 15, and 22, and intradermally on days 29, 36, 43.1×10^9CIK cells were reinfused intravenously on days 11, 12, 13, and 14.Results The incidence of skin rash was 4.2% in the group A and 1.0% in the group B, and there was no statistical difference between the two groups（P=0.088）. The incidence of high fever and moderate fever was 14.2% and 25.8% in the group A, and 6.3%and 13.4% in the group B, which were statistically significantly lower in group B than in the group A（P=0.016 and P=0.003）. The total incidence of fever in the group B was statistically significantly lower than in the group A（P=0.000）.The incidence of delayed type hypersensitivity（DTH） test was 66.9% in the group A and 67.1% in the group B. There was no statistical difference between the two groups（P=0.974）. The incidence of quality of life was 54.3% in the group A and 56.0% in the group B, with no statistical difference between the two groups（P=0.772）.Dexamethasone had no effect on overall survival showed by Cox regression analysis.Conclusion Premedication with dexamethasone can be considered as an effective option in the immunotherapy with DCs and CIK cells for cancer.

关 键 词：地塞米松 树突状细胞 杀伤细胞 肿瘤 

分 类 号：R977.1[医药卫生—药品]