光动力联合细胞疗法治疗中晚期食管癌的临床疗效

Photodynamic therapy combined with cell therapies for advanced esophageal cancer

目的:探讨光动力联合细胞疗法治疗中晚期食管癌的临床疗效及免疫效应。方法:收治中晚期食管癌患者90例,采用非随机对照的方法,按治疗意愿分为3组:A组30例,仅行单纯光动力治疗;B组30例,行光动力联合CIK治疗;C组30例,仅行单纯CIK治疗。对所有患者进行评估疗效,监测生活质量、免疫功能,随访6个月、1年死亡人数。结果:B组、A组临床总有效率均高于C组(90.0%vs.86.7%vs.63.3%,P<0.05),B组与A组疗效相当(P>0.05);B组生存质量提高率均显著高于A组、C组(86.7%vs.60.0%vs.33.3%,P<0.05),A组高于C组(60.0%vs.33.3%,P<0.05);B组CD3+、CD3+CD56+较A组、C组有明显改善(P<0.05),A组与C组比较差异无统计学意义;3组6个月生存率比较差异无统计学意义,B组1年生存率高于A组、C组(73.9%vs.55.6%vs.29.4%,P<0.05)。结论 :光动力联合细胞疗法具有免疫协同作用,能提高患者机体整体免疫功能,明显改善患者生存质量,延长生存期,显示了良好的临床前景。

Objective To explore the clinical efficacy and immunological effects of photodynamic therapy combined with cell therapies for advanced esophageal cancer. Methods Ninety patients with advanced esophageal cancer were collected and divided into three groups by a non-randomized controlled trial according to treatment intention. Group A （30 patients） received photodynamie therapy （PDT） alone; group B （30 patients）, PDT received PDT plus cytokine-induced killer （CIK） cell therapies; and group C （30 patients） received CIK cell therapy aloen. In all the patients, the efficacy was assessed, the quality of life was documented, the immune function was detected, and the 6-month and 1-year death tolls were counted. Results The total clinical effectiveness rate was much higher in groups B and A than in group C （90.0% and 86.7% vs. 63.3%, P 〈 0.05）, and there was no a statistical difference between group B and group A （P 〉 0.05）. The rate of an increase in quality of life was significantly higher in group B than in groups A and C （86.7% vs. 60.0% and 33.3%, P 〈 0.05）, and it was higher in group A than in group C （60.0% vs. 33.3%, P 〈 0.05）. As compared groups A and C, the percentages of CD3~ and CD3~ CD56~ were significantly improved in B group （P 〈 0.05）, there was no a statistical difference between group A and group C. The 6-month survival rate did not differ statistically among the three groups （P 〉 0.05）, while the 1-year survival rate was much higher in group B than in groups A and C （73.9% vs. 55.6% and 29.4%, P 〈 0.05）. Conclusion Photodynamic therapy combined with cell therapies has a synergistic effect, and it enhances the overall immune function, significantly improves the quality of life and prolongs the survival period, showing a better clinical prospect.