自体冷冻免疫瘤苗激活肿瘤浸润淋巴细胞治疗恶性黑色素瘤的疗效观察

Study of the treatment of malignant melanoma with TIL stimulated mailgnant melenoma vaccines

目的观察自体冷冻免疫瘤苗激活肿瘤浸润性淋巴细胞(TIL)配合白细胞介素-2(IL-2)、DDAVC及化疗方案治疗晚期恶性黑色素瘤的临床效果。方法60例晚期恶性黑色素瘤患者,随机分成两组。治疗组30例,采用TIL配合IL-2和DDAVC方案治疗。对照组30例采用DDAVC方案化疗配合IL-2治疗,比较两组的疗效、生存期、免疫水平、毒副反应。结果治疗组有效率为73·3%,高于对照组的43·3%(P<0·05);治疗组为11个月,对照组为7个月;1、2年生存率,治疗组分别为66·67%和26·67%,均高于对照组的40%和6·67%,差异有统计学意义(P<0·05);治疗组CD3、CD4、CD4/CD8比值均较对照组有不同程度升高(P<0·05);对照组NK活性显著下降P<0·05),而治疗组则显著提高(P<0·05);两组间毒副反应无统计学意义。结论经恶性黑色素瘤冷冻瘤苗激活的TIL具有提高机体细胞免疫功能的作用,能延长患者生存期。TIL、IL-2免疫配合DAVC方案综合治疗晚期恶性黑色素瘤可以达到预期的疗效。

Objective To observe the treatment of malignant melanoma with TIL stimulated mailgant melanoma vaccines and IL-2 Dacarbazine et al.Methods 60 patients of advanced malignant melanoma were divided into two groups stochastically,The treatment group （30 patients） were treated with combined chemotherapied with the TIL .IL-2 and DDAVC plan （DDAVC is a chemotherapy projecte which use the most of Dacarbazine and Cisplatin, Doxorubicin, Vincristine, Lomustine）. The comparison group （30 patients）were treated with only chemotherapied with IL-2 and the DDAVC plan.Curative effects,life span,immunity level,toxical reaction between the two groups were compared. Results The overall response rates 73.3% of the treatment group was higher than response rates 43.3% of the comparison group（ P 〈 0.05）.The meso-lifes pan were 11 months in the treatment group and 7 months in the comparison group, 1-and 2-years survival rate in the treatment group was 66.67% and 26.67 % respectively, which were higher than those of in the comparison group, 40 % and 6.67 % （ P 〈 0.05）. The CD3.CD4, CD4/CD8 ratio of the T cell subgroup in treatment group have the different degree of increase compared with the comparison group（P 〈 0.05） .The NK activeness in the comparison group has descend significantly （ P 〈 0.05） and in the treatment group has raised significantly（ P 〈 0.05） .There were no significant deviation toxical reaction in the two groups. Conclusion The TIL stimulated by malignant melanoma vaccine can enhance the immune activity of the organism and extend the life span of patients. The patients with late malignant melanoma after combined chemotherapied with IL-2,dacarbazine and TIL can achieve prospective curative effect.