手术联合细胞治疗皮肤型黑色素瘤的疗效观察
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摘要
目的探讨利用手术治疗结合树突状细胞联合细胞因子诱导的杀伤细胞(DC-CIK)治疗皮肤型黑色素瘤(MM)的临床疗效及对生活质量的影响。方法收集59例皮肤型MM患者,按治疗方式分为两组,治疗组为手术后行DC-CIK细胞治疗,对照组为术后配合姑息治疗。并观察两组患者出现的副反应。结果与对照组相比,治疗组患者总生存期(OS)明显优于对照组(P=0.0287),无进展生存期(PFS)差异无统计学意义;治疗组3年生存率远高于对照组(P=0.012),5年生存率虽有差异但无统计学意义;细胞免疫功能及生活质量方面,治疗组明显优于对照。两组患者均未出现严重不良反应。结论手术治疗联合DC-CIK细胞治疗可延长MM患者生存期,改善患者细胞免疫状态及生活质量,提高临床疗效,无明显不良反应,值得临床推广。
Objective To retrospectively analyze the clinical efficacy of malignant melanoma on skin treated by operation combined with DC-CIK immunotherapy.Methods Patients with skin melanoma were divided into two groups according to the treatment method. 32 of them were treated by DC-CIK loaded with antigen combined with surgery(combined group) and another 27 were treated by surgery with palliative treatment(control group). The two groups of patients were followed up; the survival, survival rate, quality of life and two groups of patients with immune function were analyzed, and observed the side effects of the two groups of patients.Results Compared with the control group, the overall survival(OS) of the combined group was significantly superior to the control group(P=0.0191), and there was no significant difference in progression-free survival(PFS). The 3-year survival rate of the combined group was much higher than that in the control group(P=0.012), however, the 5-year survival rate dispalyed no significant difference(P=0.051). In the cell immune function and the quality of life, combined group was much superior to the control group.Conclusion DC-CIK cell therapy can prolong the survival period of patients with melanoma, improve the immune function and quality of life, and combine with surgical treatment is an effective combination therapy.
Objective To retrospectively analyze the clinical efficacy of malignant melanoma on skin treated by operation combined with DC-CIK immunotherapy.Methods Patients with skin melanoma were divided into two groups according to the treatment method. 32 of them were treated by DC-CIK loaded with antigen combined with surgery(combined group) and another 27 were treated by surgery with palliative treatment(control group). The two groups of patients were followed up; the survival, survival rate, quality of life and two groups of patients with immune function were analyzed, and observed the side effects of the two groups of patients.Results Compared with the control group, the overall survival(OS) of the combined group was significantly superior to the control group(P=0.0191), and there was no significant difference in progression-free survival(PFS). The 3-year survival rate of the combined group was much higher than that in the control group(P=0.012), however, the 5-year survival rate dispalyed no significant difference(P=0.051). In the cell immune function and the quality of life, combined group was much superior to the control group.Conclusion DC-CIK cell therapy can prolong the survival period of patients with melanoma, improve the immune function and quality of life, and combine with surgical treatment is an effective combination therapy.
引文
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[9] 叶真龙,金华君,钱其军.CIK细胞联合治疗恶性肿瘤的最新研究进展[J].解放军医药杂志,2015,27(1):25-30.
[10] Zhang J,Li H,Gao D,et al.A prognosis and impact factor analysis of DC-CIK cell therapy for patients with hepatocellular carcinoma undergoing postoperative TACE[J].Cancer Biol Ther,2018,19(6):475-83.
[11] Jung N C,Lee J H,Choi H J,et al.Dendritic cell immunotherapy combined with cytokine-induced killer cells effectively suppresses established hepatocellular carcinomas in mice[J].Immunol Invest,2016,45(6):553-65.
[12] Barbi J,Pardoll D,Pan F.Treg functional stability and its responsiveness to the microenvironment[J].Immunol Rev,2014,259(1):115-39.
[13] 严健,原永明,张舒,等.CD～(3+)、CD～(4+)、CD～(8+)T淋巴细胞亚群在肿瘤患者外周血中检测的临床意义[J].检验医学,2013,28(10):901-3.
[14] Rathore A S,Kumar S,Konwar R,et al.CD3+,CD4+ & CD8+ tumour infiltrating lymphocytes (TILs) are predictors of favourable survival outcome in infiltrating ductal carcinoma of breast[J].Indian J Med Res,2014,140(3):361-9.
[15] 刘洋,刘林嶓.抗原负载的DC-CIK联合化疗治疗晚期恶性黑色素瘤的临床研究[J].中国美容医学,2015,24(2):25-30.
[2] Balch C M,Gershenwald J E,Soong S J,et al.Final version of 2009 AJCC melanoma staging and classification[J].J Clin Oncol,2009,27(36):6199-206.
[3] CSCO黑色素瘤专家委员会.中国黑色素瘤诊治指南(2011版)[J].临床肿瘤学杂志,2012,17(2):159-71.
[4] Olszanski A J.Current and future roles of targeted therapy and immunotherapy in advanced melanoma[J].J Manag Care Spec Pharm,2014,20(4):346-56.
[5] 张启婷,江龙委,赵华,等.DC-CIK细胞辅助治疗黑色素瘤的临床疗效及预后分析[J].免疫学杂志,2018,34(5):421-8.
[6] Ferlay J,Soerjomataram I,Dikshit R,et al.Cancer incidence and mortality worldwide:sources,methods and major patterns in GLOBOCAN 2012[J].Int J Cancer,2015,136(5):E359-86.
[7] 程霞,张晓实,彭瑞清,等.肿瘤负荷对CIK/IL-2临床疗效的影响[J].中国肿瘤临床,2005,32(15):847-8,855.
[8] 沈季敏,刘欣.基于树突状细胞的肿瘤免疫治疗临床应用方式的研究进展[J].临床血液学杂志,2018,31(1):62-5.
[9] 叶真龙,金华君,钱其军.CIK细胞联合治疗恶性肿瘤的最新研究进展[J].解放军医药杂志,2015,27(1):25-30.
[10] Zhang J,Li H,Gao D,et al.A prognosis and impact factor analysis of DC-CIK cell therapy for patients with hepatocellular carcinoma undergoing postoperative TACE[J].Cancer Biol Ther,2018,19(6):475-83.
[11] Jung N C,Lee J H,Choi H J,et al.Dendritic cell immunotherapy combined with cytokine-induced killer cells effectively suppresses established hepatocellular carcinomas in mice[J].Immunol Invest,2016,45(6):553-65.
[12] Barbi J,Pardoll D,Pan F.Treg functional stability and its responsiveness to the microenvironment[J].Immunol Rev,2014,259(1):115-39.
[13] 严健,原永明,张舒,等.CD～(3+)、CD～(4+)、CD～(8+)T淋巴细胞亚群在肿瘤患者外周血中检测的临床意义[J].检验医学,2013,28(10):901-3.
[14] Rathore A S,Kumar S,Konwar R,et al.CD3+,CD4+ & CD8+ tumour infiltrating lymphocytes (TILs) are predictors of favourable survival outcome in infiltrating ductal carcinoma of breast[J].Indian J Med Res,2014,140(3):361-9.
[15] 刘洋,刘林嶓.抗原负载的DC-CIK联合化疗治疗晚期恶性黑色素瘤的临床研究[J].中国美容医学,2015,24(2):25-30.