DC-CIK细胞联合化疗治疗老年晚期非小细胞肺癌的疗效观察

Clinical Observation of Efficacy of DC-CIK Cell Combined with Chemotherapy for Advanced Non-small Cell Lung Cancer in Elderly Patient

目的探讨自体树突状细胞(DC)、细胞因子诱导的杀伤细胞(CIK)联合化疗对老年非小细胞肺癌患者的免疫功能、临床疗效、生活质量和毒副作用的影响。方法回顾性分析120例老年晚期非小细胞肺癌患者的临床资料。所有患者接受4个疗程的诺维苯+顺铂(NP)化疗方案。随机分为2组,每组60例患者。A组患者采用自体过继DC/CIK细胞回输2次,每次30天;B组患者DC/CIK细胞回输2次,同时每30天接受免疫治疗2次以上。评价2组间药物不良反应、疾病进展时间(TTP)和总生存率(OS)。结果 120例患者的中位生存时间为13.80个月。1、2、3年总生存率分别为60.0%,21.7%和15.0%。A组患者1、2、3年总生存率分别为56.7%、13.3%和6.7%;B组患者1、2、3年总生存率分别为63.3%、30.0%和23.3%。2组间总生存率差异存在统计学意义(P=0.037)。相比于A组,B组患者的TTP显著延长,TTP中位数从6.2个月(95%CI,5.35~9.24)提高到7.3个月(95%CI,5.45~6.95;P=0.034),且可耐受化学免疫疗法的不良反应,而A组多见化疗引起的血液系统不良反应。结论 DC-CIK细胞联合化疗治疗老年晚期非小细胞肺癌患者的疗效确切,值得临床推广。

Objective To observe the effect of of dendritic cells(DC) cytokine-induced killer cells(CIK) combined with chemotherapy on the immune function,clinical efficacy,quality of life and side effects of elderly patients with non-small cell lung cancer.Methods Clinical data of 120 cases of elderly patients with advanced non-small cell lung cancer were retrospectively analyzed.All patients received 4 courses of navelbine-platinum(NP) chemotherapy.120 patients were randomly divided into 2 groups,each with 60 cases.Group A were treated with adoptive autologous DC/CIK cell transfusion twice every 30 days.Group B received immunotherapy more than twice every 30 days on the basis of group A.The adverse effects,TTP,and OS were evaluated between the 2 groups.Results The median survival time of 120 patients was 13.80 months.1-,2-,3-year overall survival rates were 60.0,21.7 and 15.0%.1-,2-and 3-year overall survival rates of group A were 56.7,13.3 and 6.7%,and those of group B were 63.3,30.0,and 23.3%.There were significant differences(P = 0.037) in overall survival rates between the 2groups.Compared with group A,TTP of group B was significantly longer,median TTP increased from 6.2 months(95% CI,5.35~ 9.24) to 7.3 months(95% CI,5.45 ~ 6.95; P = 0.034),and adverse reactions of chemical immunotherapy were tolerable,group A mainly were chemotherapy-induced blood system adverse reactions.Conclusion DC-CIK cell combined with chemotherapy for elderly patients with advanced non-small cell lung cancer is effective,and it is worthy of promotion.