Efficiency of Adjuvant Immunochemotherapy with Cytokine-induced Killer Cells in Patients with Locall

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  To evaluate the long-term effect of adjuvant immunochemotherapy with autologue cytokine-induced killer (CIK) cells to the patierits with locally advanced gastric cancer following curative resection, and investigate the changes of hosts celluar immune functions after CIK cells therapy.Patients treated with six cycles adjuvant chemotherapy based on 5-fluorouracil (5-Fu) were randomly assigned to immunotherapy with CIK cells (received at least 3 courses of CIK cells therapy after adjuvant chemotherapy) or chemotherapy alone.151 enrolled eligible patients (77 in the control group, and 74 in the immunochemotherapy group) were analysed.One week after the first CIK cells therapy course, the percentage of CD3+, CD4+ and CD4+/CD8+ ratio increased from (50.8±8.5)%, (26.5±6.1)% and (0.9±0.4) to (62.6±11.3)%, (35.0±6.6)%, and 1.4±0.3.Two months later, the values decreased to (51.8±9.2)%, (28.0±7.6)%, and 1.0±0.2, nearly closed to the baselines.After three courses of CIK cells therapy, the values raised to (60.7±8.2)%, (34.2.0±7.1)% and 1.3±0.3, which were significantly higher than the levels detected six months after adjuvant chemotherapy in the control group (53.9±11.2%, 29.0±8.3%, and 1.1±0.3 respectively).At 50.5 months follow-up, the 5-year overall survival rates were 23.4% versus 32.4% (P=0.071).The 5-year disease-free survival rate were 10.4% in the control group versus 28.3% in the immunochemotherapy group (P=0.044).A retrospective subgroup analysis by Laurens histological type showed that, for the patients with intestinal-type tumors, the 5-year OS rate and 5-year DFS rate was 46.8% and 42.4%, respectively, in the immunochemotherapy group, versus 31.4% and 15.7%, respectively, in the chemotherapy group (P=0.045 and P=0.023, respectively).These results indicate that CIK cells therapy is helpful to improve the hosts immune functions, but multi courses of therapy are necessary to gain long-term therapeutic efficacy.Adjuvant immunochemotherapy with CIK cells is effective in the prolongation of disease-free survival in patients with locally advanced gastric cancer who have undergone curative gastrectomy; and may has noticeable impact on over all survival, in particular, in patients with intestinal-type tumors.
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