DC-CIK联合手术治疗原发性肝癌的临床研究

DC-CIK combined with surgical therapy for primary liver cancer

目的 观察树突状细胞诱导的杀伤细胞联合手术治疗原发性肝癌的临床疗效.方法 将78例原发性肝癌患者随机分为实验组和对照组,实验组30例,行肝癌切除术,术后行树突状细胞诱导的杀伤细胞治疗;对照组48例,仅行肝癌切除术.观察免疫治疗不良反应,比较两组的中位复发时间、疾病无进展生存时间、生存时间和生存质量(KPS评分).结果 实验组共行树突状细胞诱导的杀伤细胞治疗78次,平均2.6次/人.细胞治疗后有8例出现发热,一周期细胞免疫治疗后实验组KPS评分改善20例,稳定8例,恶化2例,对照组改善10例,稳定32例,恶化6例,差异有统计学意义(P＜0.05);两组1、2、3年无进展生存率分别为73.3％ 、40.0％、23.3％和68.7％ 、27.0％、14.5％,实验组高于对照组,差异有统计学意义(P＜0.05);实验组中位复发时间为(16.9±2.6)个月,对照组中位复发时间为(13.5±2.9)个月,差异有统计学意义(P＜0.05);实验组、对照组1、2、3年生存率分别为85.0％、50.0％、35.0％和80.0％、40.0％、23.3％,差异无统计学意义(P＞0.05).结论 树突状细胞诱导的杀伤细胞联合手术治疗原发性肝癌安全有效,可以改善患者生存质量、延缓复发时间,提高患者疾病无进展生存时间,但并不能提高长期生存率.

Objective To evaluate the clinical efficacy of dendritic cells-cytokine induced killer cells combined with surgical treatment for primary liver cancer.Methods Totally 78 patients with primary liver cancer were randomly divided into experiment group (n =30) and control group (n =48).The patients in experiment group received hcpatectomy combined with dendritic cells-cytokine induced killer cell treatment while those in control group were given hepatectomy treatment.The median time to recurrence,progression-free survival,survival and quality of life were evaluated.Observed side effects of cell therapy in experiment group.Results Experiment group received a total of dendritic cells-cytokine induced killer cell treatment 78,an average of 2.6 times per person.Fever occured in 8 patients who received dendritic cells-cytokine induced killer cell treatment.After one cycle of immune therapy,the KPS score of 20 cases was improved,8 cases were stable and and 2 case was worsen in the experiment group.The KPS score of 10 cases were improved,32 cases were stable and and 6 cases were worsen in the control group,and the difference is statistically significant (P ＜ 0.05).The progression-free survival rates for 1,2 and 3 years in the experiment group were 73.3％,40.0％,23.3％ and 68.7％,27.0％,14.5％ in the control groups,respectively.The progression-free survival rates in the experiment group were improved compared to the control group and the difference is statistically significant (P ＜ 0.05).The median time of recurrence in the experiment group were (16.9 ± 2.6) months and (13.5 ± 2.9) months in the control group,respectively (P ＜ 0.05).The 1-2-3-years survival rates in the experiment group were 85.0％,50.0％,35.0％ and 85.0％,40.0％,23.3％ in the control group respectively.There was no statistically significant difference between these two groups (P ＞ 0.05).Conclusions Dendritic cellscytokine induced killer cells combined with surgical treatment on primary liver cancer is safe and effective,it can improve quality of life,and delay the recurrence time after surgery.But not improve long-term survival.