摘要
目的探讨放化疗联合树突细胞-细胞因子诱导的杀伤细胞(DC-CIK)疗法的临床疗效。方法回顾性分析41例直肠癌根治术后行放化疗联合DC-CIK细胞疗法患者的临床资料,以性别、年龄、肿瘤分化程度、AJCC(1997)中的TNM临床分期、手术方式、术后辅助化疗的方案、是否实施全直肠系膜切除术、是否接受术后辅助放疗为指标,采用1∶2配对方法在同期接受直肠癌根治术但未接受DC-CIK细胞疗法的患者中选择82例作为对照,采用Kaplan-Meier法计算生存率,采用单因素和多因素Cox回归法分析直肠癌的预后影响因素,对比两组的3年生存率(OS)和3年无病生存率(DFS)。结果单因素分析表明,肿瘤分化程度、TNM分期、是否实施全直肠系膜切除术、是否实施DC-CIK治疗为直肠癌预后的影响因素。术后辅助放疗是Ⅱ、Ⅲ期直肠癌的预后影响因素。多因素回归分析表明,TNM分期、是否实施全直肠系膜切除术、是否接受术后辅助放疗、是否实施DC-CIK治疗是Ⅱ、Ⅲ期直肠癌的独立预后因素。DC-CIK治疗组3年生存率(OS)(73.2%vs56.1%),差别具有统计学意义(P<0.05)。DC-CIK治疗组3年无病生存率(DFS)(58.5%vs41.5%),差别具有统计学意义(P<0.05)。结论TNM分期、是否实施全直肠系膜切除术、是否接受术后辅助放疗、是否实施DC-CIK治疗是Ⅱ、Ⅲ期直肠癌的独立预后因素。直肠癌根治术后放化疗联合DC-CIK细胞疗法有可能改善患者的远期生存率和无病生存率。
Objective To evaluate the effect of chemotherapy and radiotherapy combined with dendritic cells and cytokine-indueed killer cells （DC-CIK） on rectal cancer after radical resection. Methods A retrospective review was conducted to study the clinical data of 41 patients treated by adjuvant chemotherapy and radiotherapy combined with DC-CIK after radical resection. These patients were compared with a cohort of 82 rectal cancer patients treated by adjuvant chemotherapy and radiotherapy only after radical resection in terms of gender, age, the histologic type, the AJCC （1997） stage, surgical methods, adjuvant chemotherapy programs, reception of total mesorectal excision and adjuvant radiotherapy. The survival rate was analyzed by Kaplan-Meier method. The clinical characteristics and pathologic features were compared with the aid of monofactorial and multifactorial Cox regression analyses. Results Univariate analysis showed that differentiation degree of tumor level, reception of total mesorectal excision, TMN staging, and the treatment of DC-CIK were significant factors influencing the prognosis and that postoperative adjuvant radiotherapy had influence over survival rates of patients with stage Ⅱ and Ⅲ rectal carcinoma. Multivariate analysis found that reception of total mesorectal excision, TMN staging, the treatment of DC-CIK, and adjuvant radiotherapy were the independent risk factors for the prognosis of stage Ⅱ and Ⅲ rectal carcinoma. The 3-year survival rate of the DC-CIK treatment group was significantly higher than that of the control group （P〈0.05）. The 3-year disease-free survival rate of the DC-CIK treatment group was significantly higher than that of the control group （P〈0.05）. Conclusion Reception of total mesoreetal excision,TMN staging, adjuvant radiotherapy, and the treatment of DC-CIK are the independent prognostic factors for patients with stage Ⅱ and Ⅲ rectal carcinoma. The treatment of chemotherapy and radiotherapy combined with DC-CIK can improve the disease-free survival rate and the overall survival rate of rectal cancer patients.
出处
《福建医科大学学报》
2009年第6期483-487,共5页
Journal of Fujian Medical University
基金
福建省自然科学基金(F00019)
关键词
直肠肿瘤
化学疗法
辅助
树突细胞
细胞因子类
存活率
rectal neoplasms
chemotherapy, adjuvant
dendritic cells
cytokines
survival rate
