Therapeutic outcomes of autologous CIK cells as a maintenance therapy in the treatment of lung cancer patients: A retrospective study
Therapeutic outcomes of autologous CIK cells as a maintenance therapy in the treatment of lung cancer patients: A retrospective study
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DOI：
10.1016/j.biopha.2016.10.022
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发表时间：
2016-12-01
影响因子：
7.5
通讯作者：
Zhou, Xiangdong
中科院分区：
文献类型：
--
作者：
Luo, Hu;Gong, Liang;Zhou, Xiangdong
目的：少数临床研究证实了苦参碱诱导的杀伤细胞（CIK）在晚期肺癌患者维持治疗中的作用。我们研究CIK作为维持疗法治疗晚期肺癌患者的有效性和耐受性。方法：70例晚期肺癌患者于2011年11月至2015年1月在重庆第三军医大学第一附属医院住院并接受CIK治疗的IIIB至IV期患者作为CIK组（T组），另设同期接受最佳支持治疗的晚期肺癌患者70例为对照组（C组）。比较两组患者免疫系统的变化、有效率、疾病控制率、总生存期及不良反应。结果：肺癌患者外周血CD 3+、CD 4+、CD 8 + T细胞比例较正常人明显降低（P < 0.05），CD 8 + T细胞比例较正常人明显降低（P < 0.05）。经CIK治疗后，CD 3+、CD 4 + T细胞比值及CD 4 +/CD 8+比值均显著升高（P < 0.05）。CIK组有效率（RR）和疾病控制率（DCR）分别为34.3%和80.0%，明显高于对照组（11.4%和54.3%，P均< 0.05）。CIKs组中位无进展生存时间（PFS）明显高于对照组（6个月vs.4个月，P < 0.05）。CIK组中位OS为28个月，对照组中位OS为22个月，两组间无显著性差异（P > 0.05）。CIK组2、3年生存率分别为56.8%、21.6%，均明显高于对照组（P < 0.05）。CIK组KPS评分显著增加（P = 0.001）。6例患者在输注CIK过程中出现一过性发热或寒战，无其他不良反应。结论：CIKs维持治疗对晚期肺癌患者安全有效，能改善患者的免疫失衡、RR、DCR、PFS、OS及生活质量。(C)2016 Elsevier Masson SAS。All rights reserved.
Objective: Few clinical studies have confirmed the role of cytokine-induced killer cells (CIKs) in the maintenance therapy of advanced lung cancer patients. We investigate effectiveness and tolerability of CIKs as a maintenance therapy in the treatment of advanced lung cancer patients.Methods: 70 patients with advanced lung cancer (stage IIIB to IV) admitted to the First Affiliated Hospital of Third Military Medical University in Chongqing from Nov. 2011 to Jan. 2015 and treated with CIKs were enrolled as a CIKs group (T group), and another 70 advanced lung cancer patients treated with optimal supportive care during the same period were enrolled as a control group(C group). The changes of immune system, response rate, disease control rate, overall survival, and side effects were compared between the two groups. Furthermore, the factors that might influence the efficacy of CIKs therapy were evaluated.Results: Compared with the healthy people, the ratios of CD3(+), CD4(+) and CD8(+) T cells significantly decreased (P < 0.05) in lung cancer patients. After CIKs treatment, the ratios of CD3(+) and CD4(+) T cells and CD4(+)/ CD8(+) significantly increased (P < 0.05). The response rate (RR) and disease control rate (DCR) were 34.3% and 80.0% in the CIKs group, which were significantly higher than those in the control group (11.4% and 54.3%, both P < 0.05). Besides, the median PFS was significantly improved in the CIKs group than that in control group (6 months vs. 4 months, P < 0.05). Although median OS was 28 months in CIKs group while 22 months in control group, no significant difference was observed (P > 0.05). However, The 2-year, 3-year survival rates were 56.8% and 21.6% in the CIK group, respectively, which were significantly improved compared to that in the control group (both P < 0.05). KPS score significantly increased in the CIKs group (P = 0.001). 6 patients suffered from transient fever or chills in the process of CIKs transfusion, and no other side effect was observed. Furthermore, we also found that TNM stage, tumor size, metastasis in vital organs and KPS score were all factors associated with efficacy of CIKs treatment.Conclusion: CIKs treatment, as a maintenance therapy, is safe and effective for advanced lung cancer patients, and can also improve the immune imbalance, RR, DCR, PFS, OS and quality of life of the lung cancer patients. (C) 2016 Elsevier Masson SAS. All rights reserved.