胃癌术后化疗联合自体肿瘤细胞抗原致敏DC-CIK细胞治疗的疗效

Efficacy of chemotherapy combined with autologous tumor antigen load dendritic cells-cytokine induced killer cell therapy in the treatment of gastric cancer patients after surgery

目的:探讨进展期胃癌根治术后化疗联合自体肿瘤细胞抗原致敏树突状细胞-细胞因子诱导的杀伤(autologous tumor antigen load dendritic cells-cytokin-induced killer,Ag-DC-CIK)细胞治疗的疗效和安全性。方法:收集2013年1月至2014年3月于荆州市中心医院胃肠外科诊断为进展期(Ⅱ期和Ⅲ期)胃癌的60例患者,均接受胃癌D2根治术,术后按照随机数字表法分为两组,单纯化疗组采用FOLFOX化疗方案,给予6个周期化疗;联合治疗组除给予上述化疗外,同时给予Ag-DC-CIK细胞进行治疗。随访期2年,观察两组患者2年OS和PFS、外周血T细胞亚群免疫学指标(CD3+、CD4+、CD8+、CD3+CD56+)、生活质量评分、化疗不良反应分级。结果:联合治疗组患者2年OS及PFS较单纯化疗组明显提高(均P<0.05)。联合治疗组治疗前后外周血T细胞亚群水平无明显变化(P>0.05),而单纯化疗组治疗后外周血T细胞亚群水平明显降低(P<0.05),且明显低于联合治疗组(P<0.05);联合治疗组的综合生活质量评分明显高于单纯化疗组[(7.25±1.56)vs(5.54±1.27)分,P<0.05]。联合治疗组不良反应发生率明显低于单纯化疗组(10.0%vs 20.0%,P<0.05)。结论:Ag-DC-CIK细胞治疗联合化疗能显著提高胃癌术后患者的2年OS及PFS,保护机体的免疫功能,减少化疗的不良反应,改善其生活质量。

Objective：To explore the clinical efficacy and safety of chemotherapy combined with autologous tumor antigen load dendritic cells cytokin induced killer （Ag DC CIK） cell therapy in the treatment of gastric cancer patients after D2 surgery. Methods： The present study enrolled 60 patients with gastric cancer in progressive stage （stage Ⅱ, stage Ⅲ） who underwent D2 surgery in the department of gastrointestinal surgery, Jingzhou Central Hospital during January, 2013 to March, 2014. The patients were randomly divided into chemotherapy group （FOLFOX regimen for 6 cycles） and combined treatment group （FOLFOX chemotherapy for 6 cycles＋Ag DC CIK cell therapy）. The patients were followed up for two years. The two year overall survival （OS） and progression free survival （PFS）, the levels of T cell subsets in the peripheral blood （CD3＋ , CD4＋, CD8＋, CD3＋CD56＋）, quality of life and adverse reactions were evaluated in the two groups. Results： Compared to the chemotherapy group, the two year OS and PFS were significantly higher in combined treatment group （both P〈005）. There was no significant difference in level of T cell subsets in peripheral blood of patients between pre treatment and post treatment in combined treatment group （P〉0.05）; however, the level of T cell subsets in the peripheral blood of patients of chemotherapy group decreased significantly （P〈0.05）, and it was significant lower than that of combined treatment group （P〈0.05）. Compared to the chemotherapy group, the combined treatment group had higher quality of life （[7.25±1.56] vs [5.54±1.27], P〈0.05） and lower adverse reactions （100% vs 20.0%, P〈0.05）. Conclusion： Ag DC CIK cell therapy in combination with chemotherapy, compared with chemotherapy alone, can obviously increase the two year OS and PFS, protect the immune function of patients, reduce the adverse reactions and improve quality of life for gastric cancer patients.