DC-CIK在前列腺癌治疗中耐受性的临床研究

Clinical research on tolerance of DC-CIK in treatment of prostate cancer

目的探讨（DC-CIK）免疫细胞治疗前列腺癌的耐受性、生活质量及不良反应。方法 2014年11月～2015年12月前列腺癌患者36例,行手术包括开放的（2例）或腹腔镜（22例）前列腺癌根治术和放射性粒子植入术（12例）（经会阴）,术后应用DC-CIK免疫细胞治疗3个周期。对照组36例,术后未应用（DC-CIK）免疫细胞治疗。3个周期后评价肝肾功能、耐受性、不良反应、生活质量。结果 36例前列腺癌患者在完成DC-CIK免疫细胞治疗3个周期后肝功、肾功毒性反应均为0度。患者总体生活状况治疗后明显提高,评分差异有统计学意义（P〈0.05）;3个症状领域的疲乏、疼痛、恶心呕吐明显改善,评分差异有统计学意义（P〈0.05）;治疗3周期后卡氏评分（Karnofsky）评分明显提高,与治疗前比较,差异有统计学意义（P〈0.05）。36例患者中2例在输注后体温升高,最高达39.0℃;1例体温达41℃;1例出现下肢轻微水肿,2d后消失;1例出现困乏,5h后缓解。结论腹腔镜或开放的根治性前列腺切除术和放射性粒子植入术后,联合DC-CIK免疫细胞治疗3周期后与对照组相比患者肝肾功能无明显变化、耐受性良好、不良反应轻微、生活质量改善明显。但是远期疗效及影响缺乏确切资料,需进一步观察与研究。治疗过程中个别患者出现发热、困乏、双下肢水肿,但需高度重视、早期发现、早期处理。

Objective To discuss the tolerance,life quality and adverse reaction of DC-CIK in treatment of prostate cancer. Methods A total of 36 patients with prostate cancer treated in our hospital from November 2014 to December2015 were selected and given open（in 2 patients） or laparoscopic（in 22 patients） radical prostatectomy and transperineal radioactive seed implantation（in 12 patients）. The patients were treated by DS-CIK for three cycles after operation. Another 36 patients were selected as the control group, who were not treated by DS-CIK after operation. The liver and kidney function, tolerance, adverse reaction, and quality of life were evaluated after 3 cycles. Results 36 cases of prostate cancer with complete DC-CIK immune cells of 3 cycles treatment, the liver function and kidney toxicity both 0degree; The general living condition of patients improved significantly after treatment, with statistically significant difference（P〈0.05）; three symptoms of fatigue, pain, nauseas were significantly improved, with statistically significant difference（P〈0.05） and the score of Karnofsky apparently improved after 3 cycles treatment. Among the 36 patients after infusion treatment,2 cases had high temperature up to 39℃,one case of 41℃; 1 patient had edema of the lower extremity, but disappeared after 2 days;1 case had symptom of sleepy, remission after 5 hours. Conclusion The liver and kidney functions of patients who are given open or laparoscopic radical prostatectomy and transperineal radioactive seed implantation combined with three cycles of DC-CIK after operation are comparable with those in the control group. Application of DC-CIK has favorable tolerance with mild adverse reaction, thus significantly improves the life quality of patients.However, there is no definite research on its long-term efficacy and effects, and further studies are expected. Fever,fatigue, and edema in lower limbs are observed in individual patients, which should be paid attention and managed as early as possible.