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联合治疗方案对晚期非小细胞肺癌患者预后及免疫功能的影响

Effect of combined therapy on prognosis andimmune function of patients with advanced non-small cell lung cancer

    摘要
  • 摘要:
      目的  探讨树突状细胞-细胞因子诱导杀伤细胞（DC-CIK）过继免疫治疗及多西他赛联合顺铂（DP）化疗方案对晚期非小细胞肺癌患者预后及免疫功能的影响。
      方法  选取60例晚期非小细胞肺癌患者为研究对象，随机分为DP化疗组（化疗组，n=30）及DC-CIK细胞过继免疫治疗联合DP化疗组（联合组，n=30）。2个疗程后，评估2组患者治疗效果、免疫功能以及不良反应发生情况。采用Kaplan-Meier比较2组患者生存情况。
      结果  治疗后，联合组客观有效率（ORR）及疾病控制率（DCR）均高于化疗组，差异有统计学意义（P < 0.05）。治疗后，2组外周血免疫球蛋白G（IgG）、免疫球蛋白A（IgA）、免疫球蛋白M（IgM）、CD3+、CD8+、自然杀伤细胞（NK）水平均高于治疗前和化疗组，差异有统计学意义（P < 0.05）；2组血清CD4+水平以及CD4+/CD8+值均低于治疗前，且联合组以上指标低于化疗组，差异有统计学意义（P < 0.05）。2组不良反应发生率比较，差异无统计学意义（P>0.05）。化疗组患者中位无进展生存期、中位总生存期分别为3.33、6.37个月，联合组分别为6.40、8.40个月。Kaplan-Meier生存分析结果显示，联合组患者生存情况优于化疗组。
      结论  DC-CIK细胞过继免疫治疗联合DP化疗方案有利于提高晚期非小细胞肺癌患者的治疗效果，改善免疫功能，延长生存期，且不增加不良反应发生风险。

     

    Abstract:
      Objective  To investigate the effects of dendritic cell-cytokine-induced killer cells (DC-CIK) cell adoptive immunotherapy combined with docetaxel and cisplatin(DP) chemotherapy on prognosis and immune function of patients with advanced non-small cell lung cancer.
      Methods  Sixty patients with advanced non-small cell lung cancer were randomly divided into chemotherapy group (DP chemotherapy, n=30) and combination group (DC-CIK cell adoptive immunotherapy combined with DP chemotherapy, n=30). After two courses of treatment, the treatment effect, immune function and adverse reactions of the two groups were evaluated, and the survival of the two groups was compared by Kaplan Meier.
      Results  After treatment, the objective response rate (ORR) and disease control rate (DCR) of the combination group were significantly higher than those of the chemotherapy group (P < 0.05). After treatment, the levels of serum immunoglobulin G (IgG), serum immunoglobulin A (IgA), serum immunoglobulin M(IgM), CD3+, CD8+, natural killer cells (NK) in the two groups were significantly higher than those before treatment and the chemotherapy group (P < 0.05). The levels of serum CD4+ and CD4+/CD8+ in the two groups were significantly lower than those before treatment, and they were significantly lower in the combination group than those in the chemotherapy group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). The median progression free survival and median overall survival in the chemotherapy group were 3.33 months and 6.37 months, respectively, and were 6.40 months and 8.40 months, respectively in the chemotherapy group. Kaplan Meier survival analysis showed that the survival of the combination group was better than that of the chemotherapy group (P < 0.05).
      Conclusion  DC-CIK cell adoptive immunotherapy combined with DP chemotherapy is beneficial to improve the therapeutic effect, enhance immune function, prolong the survival time of patients with advanced non-small cell lung cancer, and does not increase the risk of adverse reactions.

     

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