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目的探讨自体细胞因子诱导的杀伤细胞联合同步放化疗对老年性直肠癌根治术后的临床疗效和远期生存的影响。方法回顾性分析40例老年性直肠癌根治术后行放化疗联合CIK细胞疗法患者的临床资料,以年龄、性别、AJCC(1997)中的TNM临床分期、肿瘤分化程度、术后辅助化疗的方案、是否接受术后辅助放疗为指标,采用同期配对方法在接受直肠癌根治术后但未接受CIK细胞疗法的患者中选择32例作为对照,计算两组患者生存率。采用单因素和多因素Cox回归法分析老年性直肠癌的预后影响因素,对比两组的3年生存率(OS)和无病生存率(DFS)。结果单因素分析结果显示,TNM分期、肿瘤分化程度、是否实施CIK细胞治疗为老年性直肠癌预后的影响因素,术后辅助放疗是Ⅱ、Ⅲ期老年性直肠癌的预后影响因素。多因素回归分析结果表明,TNM分期、是否接受术后辅助放疗、是否实施CIK细胞治疗是Ⅱ、Ⅲ期老年性直肠癌的独立预后因素。CIK细胞治疗组与对照组比较,3年OS(75.6%和58.2%)差异有统计学意义(P﹤0.05),3年DFS(56.7%和40.6%)差异有统计学意义(P﹤0.05)。结论 TNM分期、是否接受术后辅助放疗、是否实施CIK细胞治疗是Ⅱ、Ⅲ期老年性直肠癌的独立预后因素。自体CIK细胞联合同步放化疗有可能改善患者的远期生存率和无病生存率。
Objective To investigate the effect of autologous cytokine-induced killer cells combined with concurrent chemoradiotherapy on the clinical efficacy and long-term survival after radical resection of senile rectal cancer. Methods A retrospective analysis of 40 elderly patients with rectal cancer treated with chemoradiotherapy combined with CIK cell therapy clinical data, with age, gender, AJCC (1997) TNM clinical stage, tumor differentiation, postoperative adjuvant chemotherapy regimen , Whether to accept postoperative adjuvant radiotherapy as an indicator, using the same period matching method in patients undergoing rectal cancer after radical resection but did not receive CIK cell therapy, 32 patients were selected as a control to calculate the survival rate of two groups of patients. Univariate and multivariate Cox regression analysis of prognostic factors in elderly patients with rectal cancer, compared the two groups of 3-year survival (OS) and disease-free survival (DFS). Results The results of univariate analysis showed that TNM staging, tumor differentiation and CIK cell therapy were the prognostic factors of senile rectal cancer. Postoperative adjuvant radiotherapy was the prognostic factor of stage Ⅱ and Ⅲ elderly rectal cancer. Multivariate regression analysis showed that TNM staging, whether receiving postoperative adjuvant radiotherapy, whether the implementation of CIK cell therapy is Ⅱ, Ⅲ independent prognosis of elderly rectal cancer. Compared with the control group, the difference of 3-year OS was significant (75.6% vs 58.2%) in CIK cell treated group (P <0.05) and 3-year DFS (56.7% and 40.6% . Conclusions TNM staging, whether adjuvant radiotherapy is accepted or not, whether CIK cell therapy is performed or not is an independent prognostic factor for stage II and III elderly patients with rectal cancer. Autologous CIK cells combined with concurrent chemoradiation may improve the long-term survival and disease-free survival of patients.