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

摘要

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 retrospec-tively analyzed.All patients received 4 courses of navelbine-platinum ( NP) chemotherapy.120 patients were randomly divided in-to 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 e-valuated between the 2 groups.Results The median survival time of 120 patients was 13.80 months.1-,2-,3-year overall surviv-al 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 2 groups.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 chemo-therapy for elderly patients with advanced non-small cell lung cancer is effective,and it is worthy of promotion.