CB-CIK维持治疗晚期恶性肿瘤的临床疗效分析

Clinical curative effect of CB-CIK cells maintain treatment for advanced malignant tumors

目的 分析脐血（CB）-细胞因子诱导的杀伤细胞（CIK）（CB-CIK）在维持治疗晚期恶性肿瘤中的临床疗效.方法 将168 例晚期恶性肿瘤患者分为接受静脉输注CB-CIK 的治疗组和采用最佳支持治疗的对照组,比较两组患者治疗前后细胞免疫功能变化、生活质量改善情况和近远期疗效.结果 CIK 细胞回输治疗患者,其外周血T 细胞总数增加,辅助/诱导性T 细胞（Th）、抑制/毒性T 细胞（Ts）细胞百分率上升,CD4/CD8 比值上调,B 细胞及NK 细胞数增加,与对照组相比均有统计学差异（P〈0.05）;生活质量（KPS）评分中临床显效50 例（59.5%）,有效22 例（26.2%）,无效12 例（14.3%）,临床获益率85.7%（72/84）,且临床获益率与患者治疗前KPS 评分及肿瘤类型有关,而与患者的性别、年龄及既往治疗方式无关;近期疗效评估中治疗组有效率（RR）为48.8%（41/84）,疾病控制率（DCR）为76.2%（64/84）,与对照组比较,差异有统计学意义（P〈0.05）;治疗组中位无进展生存期（PFS）、总生存时间（OS）分别为6.4 个月、11.3 个月,与对照组比较,PFS 显著延长,而OS 无明显差异;治疗3～4 个周期数患者的中位疾病进展时间（TTP）显著长于1～2 个周期数患者,差异具有统计学意义,而与大于4 个周期数的患者比较,差异无统计学意义.结论 CB-CIK 治疗能明显提高晚期肿瘤患者T 细胞免疫功能及患者生活质量,延长PFS、TTP,对OS 无影响;患者治疗前的KPS 评分、肿瘤类型及治疗周期数与临床疗效相关.

ObjectiveTo analyze the clinical curative effect of the CB-CIK cells in maintaining in treatment of advanced malignant tumor.Methods 168 patients with late malignant tumor were randomly divided into CB-CIK cells treated group by intravenous infusion and control group treated with the best support, in order to investigate the changes including cellular immune function of the two groups patients, the quality of life and the curative effect.Results The peripheral blood T cells, the total assistance/induced T cell (Th), inhibiting/toxicity T cell percentage rise (Ts) cells, CD4/CD8 ratio and the number of B cells and NK cells were increased after CIK cells treatment. The results had significant difference compared with control group (P<0.05), besides, quality of life (KPS) score in clinical 50 cases were markedly improved (59.5%), 22 cases effective (26.2%), 12 cases invalid (14.3%), the clinical benefit rate was 85.7% (72/84). The rate of clinical benefit were associated with patients KPS score and tumor types, but the patient's gender, age, and previous treatment had nothing to do. The recent curative effect&nbsp;evaluation of response rate (RR) was 48.8% (41/84), disease control rates (DCR) was 76.2% (64/84), compared with control group, the difference was statistically significant (P<0.05). The median progression-free survival (PFS) and overall survival (OS) were 6.4 months and 11.3 months in treatment group, compared with control group, PFS was prolonged, and the OS had no obvious difference. The time to progression (TTP) in patients treated for three to four cycles was significantly longer than patients with one or two cycles, the difference was statistically significant, but compared with greater than 4 cycles of patients, there was no statistically difference.Conclusion CB-CIK cell therapy can obviously improve the T cell immune function in patients with advanced cancer and QOL, prolong PFS, TTP, but OS has no effect. The KPS score of pre-treatment, tumor type and treatment cycles were related to clinical curative effect.