国际肿瘤学杂志

国际肿瘤学杂志 ›› 2016, Vol. 43 ›› Issue (5): 326-329.doi: 10.3760/cma.j.issn.1673-422X.2016.05.002

• 论著 • 上一篇    下一篇

化疗联合DC-CIK细胞免疫治疗在转移性乳腺癌中的疗效观察

高海燕,朱玉兰,孙立   

  1. 213000 南京医科大学附属常州第二人民医院乳腺外科
  • 出版日期:2016-05-08 发布日期:2016-04-07
  • 通讯作者: 高海燕 E-mail:ghy7693@sina.com

Investigation of the curative effect of chemotherapy combined with DC-CIK cell immunotherapy in metastatic breast carcinoma

Gao Haiyan, Zhu Yulan, Sun Li   

  1. Department of Breast Surgery, Second People′s Hospital of Changzhou Affiliated to Nanjing Medical University, Changzhou 213000, China
  • Online:2016-05-08 Published:2016-04-07
  • Contact: Gao Haiyan E-mail:ghy7693@sina.com

PDF

1088

摘要： 目的比较TA方案(多西他赛+表柔比星）和TA方案联合树突细胞（DC）细胞因子诱导的杀伤细胞（CIK）的免疫治疗方案在转移性乳腺癌（MBC）中的疗效和不良反应。方法分析2011年1月至2013年1月在我院接受治疗的43例MBC患者的临床资料。根据治疗方案的不同将患者分为单纯治疗组（TA方案，对照组，22例）和联合治疗组（TA方案+DCCIK细胞免疫治疗，观察组，21例）。比较两组患者的治疗疗效、临床症状改善状况、不良反应以及治疗前后患者外周血T细胞免疫表型改变。结果观察组患者的治疗总有效率（85.7%）高于对照组（63.6%），差异具有统计学意义（χ2=4.949，P=0.026）。不良反应中白细胞下降发生率最高，观察组为76.2%，对照组为59.1%，差异无统计学意义（χ2=0.858，P=0.36）。治疗后观察组患者疲倦乏力、食欲不振和失眠盗汗的发生率均低于对照组（23.8%∶54.5%，χ2=4.246，P=0.04；19.0%∶54.5%，χ2=5.795，P=0.02；19.0%∶50.0%，χ2=4.532，P=0.03）。治疗后观察组患者的CD3+T细胞(60.4±12.3∶47.4±12.8，t=3.393，P<0.01)、CD3+/CD4+（41.7±9.6∶28.1±10.5，t=5.442，P<0.01)、CD4+/CD8+(1.5±0.2∶1.0±0.2，t=8.195，P<0.01)、NK细胞(27.3±5.9∶15.3±6.1，t=6.643，P<0.01)、NK T细胞(14.7±1.4∶6.0±1.2，t=11.020，P<0.01)均显著高于对照组。结论相对于单纯TA方案，TA化疗方案联合DCCIK细胞免疫治疗在MBC中疗效更佳，可以显著改善患者的免疫功能，并未增加不良反应。

关键词: 乳腺肿瘤, 免疫疗法, 抗肿瘤联合化疗方案

Abstract: ObjectiveTo compare the efficacy and adverse reactions of TA regimen (docetaxel + epirubicin) and immunization therapy of TA regimen combined with dendritic cell (DC)cytokine induced killer cell (CIK) in treating the patients with metastatic breast cancer (MBC). MethodsClinical data of 43 patients with MBC received treatment in our hospital from January 2011 to January 2013 were retrospectively analyzed. Patients included were divided into two groups according to the treatment, simple treatment group (TA regimen, control group, 22 cases) and combined treatment group (TA regimen + DCCIK cell, observation group, 21 cases). The curative effect, improvement situation of clinical symptoms, adverse reactions and changes of T cell immune phenotype in peripheral blood of patients before and after treatment in the two groups were compared. ResultsThe total efficiency of treatment in observation group (85.7%) was higher than that in control group (63.6%), and the difference was statistical significant (χ2=4.949, P=0.026). Among the incidences of all kinds of adverse reaction appeared during the treatment in two groups, the white blood cells count decreased was the highest in observation group (76.2%) and in control group (59.1%), the difference had no statistical significance (χ2=0.858, P=0.36). After treatment, the rates of fatigue, loss of appetite, insomnia and night sweats of patients in observation group were lower than those in control group (23.8% vs. 54.5%, χ2=4.246, P=0.04; 19.0% vs. 54.5%, χ2=5.795, P=0.02; 19.0% vs. 50.0%, χ2=4.532, P=0.03). The CD3+ (60.4±12.3 vs. 47.4±12.8, t=3.393, P<0.01), CD3+/CD4+ (41.7±9.6 vs. 28.1±10.5, t=5.442, P<0.01), CD4+/CD8+ (1.5±0.2 vs. 1.0±0.2, t=8.195, P<0.01), NK cells (27.3±5.9 vs. 15.3±6.1, t=6.643, P<0.01), NK T cells (14.7±1.4 vs. 6.0±1.2, t=11.020, P<0.01) after treatment in observation group were obviously higher than those in control group. ConclusionComparing with the pure TA scheme, the curative effect of immunization therapy of TA regimen combined with DCCIK cell in treating the patients with MBC is better. It significantly improves the immune functions of patients with MBC, and does not increase adverse reaction.

Key words: Breast neoplasms, Immunotherapy, Antineoplastic combined chemotherapy protocols