链式细胞因子诱导的杀伤细胞联合放疗和微波热疗治疗局部晚期直肠癌的临床观察

Clinical efficacy of chain CIK cell immunotherapy combined with radiotherapy and microwave hyperthermia for locally advanced rectal cancer

目的探讨链式细胞因子诱导的杀伤细胞(CIK)联合放疗和微波热疗治疗局部晚期直肠癌的临床疗效。方法选取2013年1月到2014年1月青岛市胶州中心医院已确诊的64例局部晚期直肠癌患者,按照随机数字表法随机分为观察组和对照组,观察组(32例)采用链式CIK联合放疗和微波热疗治疗,对照组(32例)采用单纯放疗联合微波热疗治疗。观察比较两组患者治疗3个疗程、6个疗程和9个疗程时T细胞亚群CD3^+、CD4^+、CD8^+、CD4^+/CD8^+的变化、治疗结束后第1~6个月、1年和2年时患者的随访情况。结果观察组患者治疗效果完全缓解、部分缓解、稳定、进展比率分别为46.9%、31.4%、12.5%和6.30%;对照组为28.1%、25.0%、31.1%和15.6%。观察组患者总缓解率为78.3%,对照组为53.1%,观察组明显高于对照组(P<0.05)。观察组和对照组CD3^+和CD4^+均逐渐增大,CD8^+均减少,但与治疗前比较,观察组患者变化率明显高于对照组。9个疗程后,观察组CD4^+/CD8^+比值为(1.59±0.40),对照组为(1.44±0.46),差异有统计学意义(P<0.05)。观察组疾病控制率在1~6个月、1年、2年这3个时间段分别为96.9%、90.6%和87.5%,对照组为84.4%、78.1%和56.3%,观察组明显高于对照组,差异有统计学意义(P<0.05)。结论链式CIK联合放疗和微波热疗治疗局部晚期直肠癌可以提高患者治疗效果和免疫能力,增长患者的存活期。

Objective To explore the clinical efficacy of chain CIK cell immunotherapy combined with radiotherapy and microwave hyperthermia for locally advanced rectal cancer. Methods Sixty-four patients diagnosed with locally advanced rectal cancer were selected from Jiaozhou Central Hospital of Qingdao from January 2013 to January 2014. According to random number generator method,patients were assigned to experimental group and control group. Thirty-two patients in the experimental group received CIK cell immunotherapy combined with radiotherapy and microwave hyperthermia and 32 patients in the control group received simple radiotherapy combined with microwave hyperthermia. Local control rate after treatment,changes of CD3 ~＋,CD4 ~＋,CD8 ~＋ and CD4 ~＋ / CD8 ~＋ of T cell subsets after 3,6 and 9 cycles of treatment in two groups were observed and compared. The above referenced changes of T cell subsets in experimental group before and after treatment and overcome of the two groups during the follow up of 1 ~ 6 months,1 year and 2 years were compared. Results After treatment,complete remission,partial remission and stable progress ratios in the experimental group were46. 9 %,31. 4 %,12. 5 % and 6. 30 % and 28. 1 %,25 %,31. 1 % and 15. 6 % for the control group respectively. The total remission rate was 78. 3 % for the test group and 53. 1 % for the control group（ P〈0. 05）; For the changes of T cell subsets,CD3 ~＋ and CD4 ~＋ increased in both groups and CD8 ~＋ decreased in both groups,but compared with prior treatment,changes in the test group was significantly higher than the control group. After 9 courses of treatment,CD4 ~＋ / CD8 ~＋ ratio for the test group was 1. 59 ± 0. 40% and 1. 44 ± 0. 46% for the control group（ P〈0. 05）; Disease control rate was 96. 9%,90. 6% and 90. 6% for the experimental group at 1 ~ 6 months,1 year and 2 years and 84. 4%,78. 1%and 56. 3% for the control group respectively（ P〈0. 05）. Conclusion Chain CIK cell immunotherapy combined with radiotherapy and microwave hyperthermia for locally advanced rectal cancer can improve therapeutic effect and immune function and increase the survival time.