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目的分析脐血(CB)-细胞因子诱导的杀伤细胞(CIK)(CB-CIK)在维持治疗晚期恶性肿瘤中的临床疗效。方法将168例晚期恶性肿瘤患者分为接受静脉输注CB-CIK的治疗组和采用最佳支持治疗的对照组,比较两组患者治疗前后细胞免疫功能变化、生活质量改善情况和近远期疗效。结果 CIK细胞回输治疗患者,其外周血T细胞总数增加,辅助/诱导性T细胞(Th)、抑制/毒性T细胞(Ts)细胞百分率上升,CD4/CD8比值上调,B细胞及NK细胞数增加,与对照组相比均有统计学差异(P<0.05);生活质量(KPS)评分中临床显效50例(59.5%),有效22例(26.2%),无效12例(14.3%),临床获益率85.7%(72/84),且临床获益率与患者治疗前KPS评分及肿瘤类型有关,而与患者的性别、年龄及既往治疗方式无关;近期疗效评估中治疗组有效率(RR)为48.8%(41/84),疾病控制率(DCR)为76.2%(64/84),与对照组比较,差异有统计学意义(P<0.05);治疗组中位无进展生存期(PFS)、总生存时间(OS)分别为6.4个月、11.3个月,与对照组比较,PFS显著延长,而OS无明显差异;治疗3~4个周期数患者的中位疾病进展时间(TTP)显著长于1~2个周期数患者,差异具有统计学意义,而与大于4个周期数的患者比较,差异无统计学意义。结论 CB-CIK治疗能明显提高晚期肿瘤患者T细胞免疫功能及患者生活质量,延长PFS、TTP,对OS无影响;患者治疗前的KPS评分、肿瘤类型及治疗周期数与临床疗效相关。
Objective To analyze the clinical efficacy of cord blood (CB) -cytokine-induced killer (CIK) cells (CB-CIK) in the maintenance of advanced malignancies. Methods 168 patients with advanced malignant tumor were divided into treatment group receiving intravenous infusion of CB-CIK and the best supportive treatment of the control group, compared two groups before and after treatment of cellular immune function changes, quality of life improvement and short-term efficacy . Results The number of T cells in peripheral blood, the number of helper / inducible T cells, the percentage of suppressor / T cells increased, the ratio of CD4 / CD8, the number of B cells and NK cells (P <0.05). Among the KPS scores, 50 (59.5%) were clinically effective, 22 (26.2%) were effective, 12 (14.3%) were ineffective, The clinical benefit rate was 85.7% (72/84), and the clinical benefit rate was related to the KPS score and tumor type before treatment, but not with the patient’s gender, age and previous treatment modalities. The recent efficacy evaluation of the treatment group was effective RR was 48.8% (41/84) and disease control rate (DCR) was 76.2% (64/84), which was significantly different from the control group (P <0.05). The median progression-free survival (PFS) and overall survival time (OS) were 6.4 months and 11.3 months, PFS was significantly prolonged compared with the control group, but there was no significant difference in OS; the median disease progression time in patients with 3 to 4 cycles TTP) was significantly longer than 1 ~ 2 cycles of patients, the difference was statistically significant, but with more than 4 cycles of patients, the difference was not statistically significant. Conclusion CB-CIK treatment can significantly improve the T-cell immune function and quality of life of patients with advanced cancer, extend PFS and TTP, and have no effect on OS. The KPS score, tumor type and number of treatment cycles before treatment are correlated with clinical curative effect.