直肠癌患者术后化疗联合CIK免疫治疗的临床疗效
| 作者: |
1,2刘德宝,
3孙子雯,
4李岩,
1,2惠丽娜,
5徐忠法,
1范开席
1 山东省医学科学院附属医院内七科，山东 济南250031 2 济南大学/山东省医学科学院 医学与生命科学学院，山东 济南 250022 3 山东省医学科学院附属医院医务部，山东 济南250031 4 山东省医学科学院附属医院中心实验室，山东 济南250031 5 山东省医学科学院附属医院 外二科，山东 济南250031 |
| 通讯: |
范开席
Email: fankaixi@126.com |
| DOI: | 10.3978/.10.3978/j.issn.1005-6947.2016.08.017 |
| 基金: | 山东省医药卫生科技发展计划基金资助项目, 2013WS0371 |
摘要
目的：探讨直肠癌患者术后行化疗联合细胞因子诱导杀伤细胞（CIK）治疗的临床疗效。方法：回顾性分析2011年6月—2013年5月45例术后行FOLFOX4方案化疗联合CIK治疗的直肠癌患者（CIK+化疗组）临床资料，以同期术后仅接受相同方案的45例直肠癌患者（单纯化疗组）为对照，比较两组患者的生存质量、近期疗效、生存率以及不良反应，并分析直肠癌患者预后的影响因素。结果：与单纯化疗组比较，CIK+化疗组患者的生存质量改善率明显升高（82.2% vs. 33.3%，P<0.05）；总有效率无统计学差异（31.1% vs. 22.2%，P>0.05），但疾病控制率明显增加（77.8 % vs. 51.1%，P<0.05）；1、2年总生存率无统计学差异（100.0% vs. 97.8%；93.3% vs. 80%，均P>0.05），但1、2年无进展生存率明显升高（86.7% vs. 62.2%；62.2% vs. 40%，均P<0.05）；总不良反应发生率无统计学差异（46.7% vs. 53.3%，P>0.05）。单因素分析显示，直肠癌术后患者的预后与肿瘤的分化程度、淋巴结转移、病理分期及手术方式有关（均P<0.05）；多因素分析显示，肿瘤的分化程度和病理分期是影响直肠癌患者术后生存的独立因素（均P<0.05）。结论：直肠癌患者术后行化疗联合CIK免疫治疗可明显改善生活质量，提高总体疗效，延长无进展生存时间；肿瘤的分化程度和病理分期是影响直肠癌患者术后生存的独立因素。
关键词：
直肠肿瘤
免疫疗法
细胞因子诱导杀伤细胞
肿瘤联合化疗方案
Clinical efficacy of postoperative chemotherapy in combination with CIK immunotherapy in rectal cancer patients
CorrespondingAuthor:FAN Kaixi Email: fankaixi@126.com
Abstract
Objective: To investigate the clinical efficacy of postoperative chemotherapy combined with cytokine-induced killer cell (CIK) therapy in rectal cancer patients. Methods: The clinical data of 45 rectal cancer patients undergoing postoperative chemotherapy with FOLFOX4 regimen in combination with CIK therapy (CIK plus chemotherapy group) during June 2011 to May 2013 were retrospectively analyzed, and another 45 rectal cancer patients undergoing postoperative chemotherapy alone (chemotherapy alone group) with the same regimen during the same period served as control. The quality of life, short-term results, survival rate and adverse reactions between the two groups were compared, and the influential factors for prognosis of rectal cancer patients were also analyzed. Results: In CIK plus chemotherapy group compared with chemotherapy alone group, the improvement rate in quality of life was significantly increased (82.2% vs. 33.3%, P<0.05), the overall response rate had no significant difference (31.1% vs. 22.2%, P>0.05), but the disease control rate was significantly increased (77.8 % vs. 51.1%, P<0.05). The 1- and 2-year overall survival rate showed no significant difference (100.0% vs. 97.8%; 93.3% vs. 80%, both P>0.05), but the 1- and 2-year progression-free survival rate was significantly increased (86.7% vs. 62.2%; 62.2% vs. 40%, both P<0.05) and the overall incidence of adverse reactions showed no significant difference (46.7% vs. 53.3%, P>0.05). Univariate analysis showed that degree of tumor differentiation, lymph node metastasis, TNM stage and surgical procedure were associated with the prognosis of rectal cancer patients (all P<0.05), and multivariate analysis identified that degree of tumor differentiation and pathological stage were independent prognostic factors (both P<0.05). Conclusion: Postoperative chemotherapy in combination with CIK immunotherapy can significantly improve the quality of life, increase the overall efficacy, and prolong the progression-free survival rate of rectal cancer patients. The degree of tumor differentiation and pathological stage are independent postoperative prognostic factors for rectal cancer patients.
Keywords：