DC-CIK不同输注方式治疗原发性肝癌的临床疗效和预后

Clinical efficacy and prognosis of different infusion modes of DC-CIK for the treatment of primary liver cancer

目的:探讨不同途径输注DC-CIK对中晚期原发性肝癌(PLC)的治疗效果和预后价值。方法:回顾性分析2018年10月至2021年9月间东部战区总医院肿瘤科DC-CIK治疗的69例中晚期PLC患者的临床资料,根据DC-CIK治疗时采用的输注方式不同将患者分为肝动脉灌注(HAI)组(n=29)和静脉输注(Ⅳ)组(n=40),比较两组患者的临床疗效、外周血T淋巴细胞亚群(CD3+、CD4+、CD8+T和CD4+/CD8+T细胞比值),以及细胞因子(IL-2、IL-6、IFN-γ和TNF-α)、甲胎蛋白(AFP)的变化、总生存期(OS)和不良反应发生情况。结果:69例PLC患者经DC-CIK治疗后,HAI组患者的客观缓解率(ORR)为0%,疾病控制率(DCR)为75.8%;Ⅳ组患者的ORR为0%,DCR为72.5%(P>0.05)。两组患者治疗前后T淋巴细胞亚群指标变化差异无统计学意义(均P>0.05),两组患者治疗后外周血IL-2、IL-6、IFN-γ和TNF-α的平均水平均显著高于治疗前(均P<0.01),两组间比较无显著差异(P>0.05);HAI组患者平均OS为48.17个月,Ⅳ组OS为39.65个月,两组间比较无显著差异(P>0.05)。治疗过程中无严重不良反应发生。结论:自体DC-CIK HAI治疗PLC安全有效,较Ⅳ治疗有提升临床获益的趋势,值得临床借鉴。

Objective:To explore the therapeutic effects and prognostic value of dendritic cell and cytokine-induced killer cell(DC-CIK)infusion in different routes in the treatment of intermediate and advanced primary liver cancer(PLC).Methods:A retrospective study was conducted on the clinical data of 69 patients with intermediate and advanced PLC treated with DC-CIK at the Oncology Department of the General Hospital of the Eastern Theater of Operations between October 2018 and September 2021.The patients were divided into a hepatic arterial infusion(HAI)group(n=29)and an intravenous infusion(IV)group(n=40)according to the different infusion modes used for DC-CIK treatment.The changes in peripheral blood T lymphocyte subsets(CD3+,CD4+,CD8+T cells and CD4+/CD8+T cell ratio),cytokines(IL-2,IL-6,IFN-γ,and TNF-α),and alpha-fetoprotein(AFP)before and after treatment,treatment efficacy,overall survival(OS),and the incidence of adverse reactions were compared between the two groups.Results:After DC-CIK treatment,the objective remission rate(ORR)was 0%,and the disease control rate(DCR)was 75.8%in the HAI group;the ORR was 0%,and the DCR was 72.5%in the IV group(all P>0.05).There were no significant changes in T-lymphocyte subpopulation between the two groups before and after treatment(all P>0.05).The mean levels of peripheral blood IL-2,IL-6,IFN-γand TNF-αafter treatment were significantly higher than those before treatment in both groups(all P<0.01),but with no significant difference between the two groups(all P>0.05).The mean OS in HAI group was 48.17 months,and the OS in IV group was 39.65 months,with no significant difference between the two groups(P>0.05).No severe adverse reactions occurred during the treatment.Conclusion:Autologous DC-CIK treatment via HAI is safe and effective for PLC.Compared to IV treatment,it tends to further improve the clinical benefit,which is worthy of clinical reference.