摘要
目的:评价细胞因子诱导的杀伤细胞(cytokine-induced killer cells,CIK)免疫治疗在晚期转移性肾癌(metastatic renalcell carcinoma,MRCC)治疗中的作用。方法:连续收集天津医科大学附属肿瘤医院2002年3月至2010年7月接受CIK细胞治疗的80例MRCC患者为治疗组,88例接受IL-2联合IFN治疗的MRCC患者为对照组。配对因素包括性别、年龄、KPS评分、中性粒细胞计数、血小板、血红蛋白、乳酸脱氢酶、β2-微球蛋白、血钙、确诊至开始内科治疗的时间、转移部位数量等。观察终点为无进展生存期(progression-free survival,PFS)和总生存期(overall survival,OS)。结果:CIK治疗组患者1、2、3年无进展生存率分别为47%、28%、17%,而对照组患者分别为36%、15%、10%(P值分别为0.015、0.009、0.019)。CIK治疗组患者1、2、3年总生存率分别为87%、67%、59%,而对照组患者分别为55%、37%、18%(P均<0.001)。CIK治疗组患者的中位PFS、OS明显优于对照组(12个月vs.9个月,P=0.013:46个月vs.18个月,P<0.001)。多因素分析显示,KPS评分、转移部位数量、CIK细胞治疗的次数与CIK治疗组患者预后具有明显相关性。最佳CIK治疗次数为7次以上。结论:CIK细胞免疫治疗可以显著改善MRCC患者预后。高KPS评分、无或仅有一个转移部位的患者预后较好,且增加CIK免疫治疗次数可以使患者更大程度获益。
Objective: To evaluate the clinical efficacy and analyze the related predictive factors of cytokine-induced killer cells ( CIK ) in the treatment of patients with metastatic renal cell carcinoma ( MRCC ). Methods: Baseline characteristics and outcomes of 168 patients with MRCC were collected from the Tianjin Medical University Cancer Institute and Hospital from March 2002 to July 2010. A total of 80 patients received autologous CIK cell treatment ( CIK group ), and 88 received IL-2 treatment combined with IFN-α ( control group ). Progression-free survival (PFS) and overall survival ( OS ) were evaluated. Results: The 1-, 2-, and 3-year PFS rates in the CIK group were 47 %, 28 %, and 17 %, compared with the 36%, 15% and 10% in the control group ( P = 0.015, 0.009, and 0.019, respectively ). The 1-, 2-, and 3-year OS rates in the CIK group were 87%, 67%, and 59%, compared with 55%, 37%, and 18% in the control group ( P 〈 0.001 for all ). The median PFS and OS durations in the CIK group were significantly higher than those in the control group ( 12 months vs. 9 months, P - 0.013; and 46 months vs. 18 months, P 〈 0.001, respectively ). Multivariate analysis re- vealed that the Karnofsky performance status (KPS), number of metastatic sites, and frequency of CIK cell immunotherapy were signifi- cantly related with the OS duration. The optimal cutpoint of frequency was seven times. Conclusion: The data suggested for the first time that CIK cell immunotherapy can improve the prognosis of MRCC. Patients with higher KPS and no more than one metastatic site have a better survival rate. Increasing the frequency of CIK cell treatment seems to benefit patients more.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2012年第10期732-735,共4页
Chinese Journal of Clinical Oncology
基金
天津市应用基础及前沿技术研究计划项目(编号:09JCZDJC20400)资助~~
关键词
细胞因子诱导的杀伤细胞
转移性肾癌
过继性细胞免疫治疗
临床疗效
预后
Cytokine-induced killer cells ( CIK )
Metastatic renal cell carcinoma
Adoptive cellular immunotherapy
Clinical efficacy
Prognosis