含奥沙利铂化疗方案联合DC-CIK细胞治疗中晚期原发性肝癌的临床疗效

Clinical effects of the oxaliplatin-based chemotherapy regimen combined with DC-CIK cells on advanced primary liver carcinoma

目的:探讨含奥沙利铂(oxaliplatin,OXA)化疗方案联合树突状细胞-细胞因子诱导的杀伤(dendritic cells-cytokine-induced killer,DC-CIK)细胞治疗中晚期原发性肝癌的临床疗效和安全性。方法:回顾性分析2013年1月至2015年6月上海东方肝胆外科医院肿瘤生物治疗科收治的11例中晚期原发性肝癌患者的临床资料,患者均接受以OXA为主的方案化疗,包括FOLFOX 4方案,即OXA+亚叶酸钙(calcium folinatc,CF)+5-氟尿嘧啶(5-fluorouracil,5-FU),或GEMOX方案化疗,即吉西他滨(gemcitabine,GEM)+OXA,化疗结束后2~3 d回输DC-CIK细胞。观察指标包括疾病控制率(disease control rate,DCR)、中位肿瘤进展时间(median time to tumor progression,m TTP)、中位生存期(median overall survival,m OS)和不良反应。结果:11例患者中,获得完全缓解(CR)0例,部分缓解(PR)2例,疾病稳定(SD)5例,疾病进展(PD)4例,总有效2/11例,DCR7/11例;m TTP为4.1个月;m OS为11.3月;主要的不良反应为轻、中度消化道反应、骨髓抑制和轻度周围神经毒性等化疗毒性反应,经对症治疗后均恢复正常。结论:含奥沙利铂化疗方案联合DC-CIK细胞治疗中晚期原发性肝癌具有较好的临床疗效,不良反应较轻,患者耐受性较好,值得进一步研究。

Objective: To assess the clinical efficacy and safety of the combined therapy with oxaliplatin( OXA)-based regimen and DC-CIK( dendritic cells and cytokine-induced killer) cells for the treatment of advanced primary liver carcinoma. Methods: A retrospective analysis was carried out for 11 patients with advanced primary liver carcinoma enrolled into the Department of Biotherapy of Eastern Hepatobiliary Surgery Hospital from Jan. 2013 to Jun. 2015. All these patients received FOLFOX4( OXA + calcium folinatc [CF] + 5-fluorouracil[5-FU]) or GEMOX( gemcitabine[GEM] +OXA) chemotherapy. After 2-3 days of chemotherapy,DC-CIK cells immune therapy was administrated. Disease control rate( DCR),median time to tumor progression( m TTP),median overall survival( m OS),and adverse effects were recorded. Results: Among the 11 patients,no one had CR,2 had PR,5 had SD,and 4 had PD. The response rate and disease control rate were 2 /11 and 7 /11 respectively. The m TTP and m OS were 4. 1 months and 11. 3 months. The major side effects were mild myelosuppression,gastrointestinal reaction and peripheral nerve toxicity,which were manageable with symptomatic treatments. Conclusion: For the treatment of advanced primary liver carcinoma,the combined therapy with oxaliplatin-based regimen and DC-CIK cells is effective,and its adverse effects are mild and well-tolerated,indicating that the therapy deserves further evaluation in more clinical trials with more patients.