过继性免疫细胞输注联合免疫剥夺治疗去势抵抗性前列腺癌的疗效

Efficacy of adoptive immunocyte infusion combined with immunodeprivation in the treatment of castration resistant prostate cancer

目的:观察过继性免疫细胞输注联合免疫剥夺治疗去势抵抗性前列腺癌的临床效果。方法:收集贵州医科大学附属贵州省肿瘤医院2011—2018年35例去势抵抗性前列腺癌患者相关信息,根据不同治疗分为生物治疗组(18例)和非生物治疗组(17例)。非生物治疗组患者采用阿比特龙或多西他赛进行治疗;生物治疗组采用细胞毒T淋巴细胞(CTL)联合环磷酰胺(CTX)进行治疗,通过对比治疗前后两组患者的前列腺癌特异性抗原(PSA)变化情况、主观指标(骨痛、睡眠、体力等)改善情况及临床疗效,评价生物治疗组和非生物治疗组的疗效。结果:(1)PSA水平:治疗后,两组患者的PSA水平都有降低,生物治疗组患者PSA水平显著降低(P<0.01),且生物治疗组患者的PSA下降程度明显强于非生物治疗组(P<0.05);(2)临床疗效:患者接受CTL治疗后的临床疗效较非生物治疗组有显著改善(P<0.01);(3)主观指标:生物治疗组患者在治疗后骨痛、睡眠及体力得到明显改善,与非生物治疗组相比改善显著(P<0.01);(4)生存期:患者接受生物治疗后中位生存期延长4个月,两组相比无统计学意义(P=0.3935)。结论:CTL联合CTX治疗去势抵抗性前列腺癌,可明显降低PSA并提高疗效和患者生存质量。

Objective:To observe the clinical effect of adoptive immunocyte infusion combined with immunodeprivation in the treatment of castration-resistant prostate cancer.Methods:The information of 35 patients with castration resistant prostate cancer,who were treated in the Affiliated Guizhou Provincial Cancer Hospital of Guizhou Medical University from 2011 to 2018 was collected.According to different treatments,these patients were divided into biotherapy group(18 cases)and non-biotherapy group(17 cases).Patients in the non-biotherapy group were treated with abiraterone or docetaxel,while the patients in biotherapy group were treated with cytotoxic T lymphocytes(CTL)in combination with cyclophosphamide(CTX).The treatment efficacy in the biotherapy group and the non-biotherapy group was evaluated by comparing the changes of prostate cancer-specific antigen(PSA),improvement of subjective indicators(bone pain,sleep,physical strength)and clinical efficacy before and after treatment.Results:(1)PSA level:after treatment,PSA was decreased in both groups;the biotherapy group had an obvious decrease(P<0.01),which was more significant than the decrease in non-biotherapy group(P<0.05).(2)Clinical efficacy:The clinical efficacy of patients after CTL treatment was significantly different from that of non-biotherapy group(P<0.01).(3)Subjective indicators:The bone pain,sleep and physical strength of the patients in the biotherapy group were significantly improved after treatment,and there was a significant difference as compared with patients of the non-biological treatment group(P<0.01).(4)Overall survival:The median survival of the patients receiving biotherapy was 4 months longer than patients from non-biological treatment group,but the difference was insignificant(P=0.3935).Conclusion:CTL combined with CTX in the treatment of castration resistant prostate cancer can significantly reduce PSA and improve the quality of life of patients.