DC-CIK细胞联合全身静脉化疗治疗晚期结直肠癌伴弥漫性肝转移临床疗效分析

Clinica therapeutic effects of DC-CIK cells immunotherapy with FOLFOX regimen on advanced colorectal cancer with diffusely hepatic metastasis

目的:探讨细胞因子诱导的杀伤细胞(cytokine-induced killer cells,CIK)与同源树突状细胞(dendritic cells,DC)共培养后DC-CIK细胞联合全身静脉化疗对晚期结直肠癌伴弥漫性肝转移的临床疗效。方法:选取我科2008年1月至2010年12月的18例晚期结直肠癌伴弥漫性肝转移患者,分为FOLFOX组(F组)和DC+CIK+FOLFOX组(DCF组),每组9例,F组采用FOLFOX方案进行静脉化疗,而DCF组采用DC-CIK治疗方案联合FOLFOX方案进行治疗。结果:F组9例患者中完全缓解(complete remission,CR)0例,部分缓解(partial remission,PR)2例,总的客观缓解率(objective response rate,OR)为28.6%;DCF组中CR 2例,PR 5例,有效治疗率为87.5%,高于F组(P<0.05);2组临床受益率(clinical benefit rate,CBR)判定结果无明显差异。在免疫学指标检测中,DCF组治疗前后CD4+、CD8+、CD4+/CD8+比值相比较显著提高,差异具有统计学意义(P<0.05),而F组无明显变化。消化道肿瘤标志物检测发现F组在治疗过程中变化不明显,治疗结束后明显升高,而DCF组治疗过程中缓慢下降,治疗结束呈稳定状态;2年生存率F组为0,而DCF组为33.3%,高于F组(P<0.05)。结论:DC-CIK细胞治疗方案联合FOLFOX方案进行治疗晚期结直肠癌伴弥漫性肝转移能够显著延长患者生存时间,值得临床推广和应用。

Objective：To assess the therapeutic effects of dendritic cell-cytokine-induced killer（DC-CIK） cell immunotherapy with FOLFOX regimen on advanced colorectal cancer with diffusely hepatic metastasis. Methods：Totally 18 patients with advanced colorectal cancer with diffuse hepatic metastasis from January 1,2008 to December 31,2010 were divided into 2 groups：FOLFOX group （group F） and DC＋CIK＋FOLFOX group（group DCF） ,9 patients in each group. Patients in group F were treated by FOLFOX regimen while those in group DCF were treated by DC-CIK cells immunotherapy with FOLFOX regimen. Results：In group F, 0 patient attained complete remission （CR）, 2 patients attained partial remission （PR） with effective treatment rate of 28.6%. In group DCF, 2 patients attained CR, 5 patients attained PR with effective treatment rate of $7.5%, significantly higher than that of group F（P〈0.05）. There was no significant difference in clinical benefit rate （CBR） between two groups. In the detection of immunological indexes, CD4＋、CD8＋ and value ofCD4＋/CD8＋were significantly raised after the treatment in group DCF,with statistically differences（P〈0.05） ,while no significant difference in group F was observed. In group F, markers of gastrointestinal tumors were not significantly changed during the treatment, but were increased significantly after the treatment. In group DCF, markers of gastrointestinal tumors were decreased slowly during the treatment and were kept stable after the treatment. The 2-year survival rate was 0 in group F and was 33.3% in group DCF, with significantly statistical differences（P〈0.05）. Conclusions：DU-CIK cell immunotherapy with FOLFOX regimen can prolong the survival time in the treatment of advanced colorectal cancer with diffusely hepatic metastasis and deserves clinical spread and application.