摘要
目的比较局部晚期NSCLC采用放化疗与放化疗联合CIK过继免疫疗法治疗的疗效。方法回顾分析2011—2012年间收治的125例未行手术的局部晚期NSCLC 患者资料，其中102例放化疗（对照组）、23例放化疗联合CIK过继免疫治疗（综合治疗组）。采用倾向评分匹配法对两组进行1﹕2匹配，考虑因素包括肿瘤分期、放化疗方案、放化疗后疗效等，匹配后共59例（37、22例）患者入组，比较两组生存及肿瘤控制情况。 Kaplan－Meier法计算生存率并Logrank法检验和单因素预后分析。结果对照组和综合治疗组1、2、3年OS分别为73％、32％、16％和91％、59％、41％（ P＝0．030），PFS分别为61％、21％、17％和45％、10％、10％（ P＝0．538）；ⅢB 期的3年OS分别为11％和47％（ P＝0．026），序贯放化疗的3年OS分别为11％和46％（ P＝0．003）；鳞癌患者的3年DMFS分别为22％和73％（ P＝0．029）。两组不良反应发生率相近，放射性肺炎发生率分别为9％和15％（ P＝0．889），放射性食管炎发生率分别为12％和7％（ P＝0．097）。结论放化疗联合CIK有可能使部分局部晚期NSCLC患者生存获益，但其应用人群、时机及剂量安全仍需进一步研究。
Objective To investigate and compare the clinical effects of radiochemotherapy alone or in combination with adoptive immunotherapy with cytokine-induced killer （ CIK） cells in patients with locally advanced non-small cell lung cancer （NSCLC）.Methods The clinical data of 125 patients with locally advanced NSCLC who were admitted from 2011 to 2012 and did not undergo surgery were analyzed retrospectively, and among these patients, 102 received radiochemotherapy alone （ control group） , and 23 received radiochemotherapy combined with adoptive immunotherapy with CIK cells （ multimodality therapy group） .The two groups were matched at a ratio of 1：2 using propensity score matching, and the factors considered included tumor stage, radiochemotherapy regimen, and outcome after radiochemotherapy.Then 59 patients （ 22 from the multimodality therapy group and 37 from the control group） were enrolled, and survival and tumor control were compared between the two groups.The Kaplan-Meier method was used to calculate survival rates and the log-rank test was used for survival difference analysis and univariate prognostic analysis.Results The 1-, 2-, and 3-year overall survival （ OS） rates were 73%, 32%, and 16%, respectively, in the control group, and 91%, 59%, and 41%, respectively, in the multimodality therapy group （ P=0.030） .The 1-, 2-, and 3-year progression-free survival rates were 61%, 21%, and 17%, respectively, in the control group, and 45%, 10%, and 10%, respectively, in the multimodality therapy group （ P=0.538） .As for the patients with stage ⅢB NSCLC, those in the multimodality therapy group had a significantly higher 3-year OS rate than those in the control group （47%vs.11%, P=0.026）. In the patients receiving sequential chemoradiotherapy, those in the multimodality therapy group had a significantly higher 3-year OS rate than those in the control group （ 46%vs.11%, P=0.003） .As for the patients with squamous cell carcinoma, those in the multimodality therapy group had a significantly higher 3-year distant metastasis-free survival rate than those in the control group （ 73%vs.22%, P=0.029） .The two groups showed similar incidence rates of adverse events, and compared with the control group, the multimodality therapy group had a lower incidence rate of radiation pneumonitis （9%vs.15%, P=0.889） and a higher incidence rate of radiation esophagitis （12%vs.7%, P=0.097）.Conclusions Some patients with locally advanced NSCLC can benefit from radiochemotherapy combined with adoptive immunotherapy with CIK cells, but the intended population, timing, and dose safety still need further investigation.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2016年第4期345-350,共6页
Chinese Journal of Radiation Oncology
基金
国家自然科学基金（81372429）
关键词
肺肿瘤/放化疗法
肺肿瘤/免疫疗法
预后
Lung neoplasms/radiochemotherapy
Lung neoplasms/immunotherapy
Prognosis
