化疗联合细胞因子诱导的杀伤细胞治疗晚期食管癌的疗效

Efficacy of chemotherapy combined with cytokine-induced killer cells in treatment of advanced esophageal carcinoma

目的:评价化疗联合细胞因子诱导的杀伤细胞(CIK)治疗晚期食管癌的疗效。方法:40例非手术治疗的晚期食管癌患者分2组化疗,每组20例。单纯化疗组:顺铂(25mg/m2,静脉滴注,第1～3天)、四氢叶酸钙(100mg,静脉滴注,第1～5天)和5-氟尿嘧啶(500mg/m2,静脉滴注,第1～5天),每3周1次,每2个周期评价疗效,进展患者改为紫杉醇(135mg/m2,静脉滴注,第1天)和顺铂(25mg/m2,静脉滴注,第1～3天),每3周1次。最多化疗6个周期。联合治疗组:化疗方案同上,在每周期化疗间歇期回输CIK6～8次。观察2组患者近期疗效、生活质量、外周血淋巴细胞表型及生存率。结果:联合治疗组和单纯化疗组近期疗效有效率均为35%,疾病控制率分别为65%和50%,差异均无统计学意义(χ2分别为<0.001和0.921,P均>0.05);肿瘤进展时间分别为(8.9±1.1)和(6.7±0.7)个月(t=7.295,P<0.001);1a生存率分别为75%、40%(χ2=5.013,P=0.025)。联合治疗组患者外周血CD3+、CD4+、CD4+CD8+、CD3+CD56+细胞的比例及KPS评分较治疗前升高(t分别为11.344、13.056、3.891、16.844及3.025,P<0.05),单纯化疗组无明显变化(P>0.05)。结论:化疗联合CIK治疗晚期食管癌较单纯化疗有潜在的优势。

Aim：To evaluated the clinical efficacy of chemotherapy combined with cytokine-induced killer（CIK） biotherapy for the treatment of advanced esophageal cancer.Methods：A total of 40 advanced esophageal cancer patients were divided into two groups.Chemotherapy alone group：cisplatin（25 mg/m2,iv Day 1~3,leucovorin 100 mg,iv,Day 1~5） and 5-fluorouracil（500 mg/m2,iv,Days 1~5）.Response to treatment were evaluated after two cycles.Patients with disease progression received paclitaxel（135 mg/m2,iv,Day 1） and cisplatin（25 mg/m2,iv,Days 1~3）.treatment cycles were repeated every 3 weeks for a maximum of six cycles.Combined therapy group：chemotherapy plus CIK cell transfusion,6~8 times every cycle.The CIK cells were induced from the HLA-haploidentical healthy donors＇ peripheral mononuclear cells in vitro.Results：In chemotherapy alone group and combined therapy group,the overall response rate was same as 35%,the disease control rate was 50% and 65%（χ2 was0.001,0.921,P0.05）;the time to progression was（6.7±0.7） and（8.9±1.1） months（t=7.295,P0.001）;One year survival rate was 45% and 75%（χ2=5.013,P=0.025）.The CD3＋、CD4＋、CD4＋CD8＋、CD3＋CD56＋ level were significantly higher after treatment and karnofsky＇s performance status was improved in combined therapy group（t was 11.344,13.056,3.891,16.844,and 3.025,P0.05）,while the differences in these indexes in chemotherapy alone group were not significant（P0.05）.Conclusion：Chemotherapy plus CIK has potential benefits compared to chemotherapy alone for advanced esophageal cancer treatment.