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目的:探讨树突状细胞(dendritic cells,DCs)-细胞因子诱导的杀伤细胞(cytokine induced killer,CIK)免疫治疗联合经导管动脉化学栓塞(transcatheter arterial chemoembolization,TACE)在原发性肝癌治疗中的临床疗效及不良反应。方法:以2013年1月—2015年3月收治的52例原发性肝癌患者为研究对象,影像学上有可见病灶,但无远处转移,所有患者经TACE治疗,按照是否联合DCs-CIK免疫治疗将其分为对照组(TACE单独治疗)27例与观察组(TACE联合DCs-CIK细胞免疫治疗)25例;比较2组患者的临床疗效、无进展生存(progression-free survival,PFS)、总生存(overall survival,OS)、1年生存率、生活质量及免疫治疗后不良反应的发生情况。结果:观察组的临床总有效率为80.0%,明显高于对照组的66.7%,差异具有统计学意义(P<0.05)。观察组的平均PFS时间为(15.61±4.34)个月、平均生存时间为(21.53±6.37)个月、1年生存率为84.0%(21/25),均明显高于对照组的(11.26±5.08)个月、(15.95±5.25)个月和62.9%(17/27),差异具有统计学意义(P值均<0.05)。治疗后,观察组的躯体功能、角色功能、认知功能、情绪功能及社会功能得分均明显高于对照组,差异具有统计学意义(P值均<0.05)。观察组在治疗中出现发热3例,腹痛1例,胃肠系统反应1例。结论:在原发性肝癌治疗中开展DCs-CIK免疫治疗联合TACE治疗,能够明显改善患者的生活质量,改善生存,而且治疗安全性较高,值得在临床中推广应用。
Objective: To investigate the effect of dendritic cells (DCs) - cytokine induced killer (CIK) immunotherapy combined with transcatheter arterial chemoembolization (TACE) in the treatment of primary liver cancer Clinical efficacy and adverse reactions. Methods: From January 2013 to March 2015, 52 cases of primary hepatocellular carcinoma (HCC) were enrolled in this study. There were some lesions on the imaging, but no distant metastasis. All patients were treated with TACE, Immunotherapy was divided into control group (TACE alone) 27 cases and observation group (TACE combined with DCs-CIK cell immunotherapy) 25 cases; the clinical efficacy, progression-free survival (PFS) , Overall survival (OS), 1-year survival rate, quality of life and incidence of adverse reactions after immunotherapy. Results: The total clinical effective rate in the observation group was 80.0%, which was significantly higher than that in the control group (66.7%). The difference was statistically significant (P <0.05). The average PFS time in observation group was (15.61 ± 4.34) months, the average survival time was (21.53 ± 6.37) months and the 1-year survival rate was 84.0% (21/25), which were significantly higher than those in control group (11.26 ± 5.08) months, (15.95 ± 5.25) months and 62.9% (17/27), respectively. The difference was statistically significant (P <0.05). After treatment, the scores of body function, role function, cognitive function, emotional function and social function in the observation group were significantly higher than those in the control group, the difference was statistically significant (P <0.05). Observation group in the treatment of fever occurred in 3 cases, 1 case of abdominal pain, gastrointestinal reaction in 1 case. Conclusion: DCs-CIK immunotherapy combined with TACE in the treatment of primary liver cancer can significantly improve the quality of life of patients and improve survival, and the treatment of high safety, it is worth in the clinical application.