紫杉醇、奥沙利铂、氟尿嘧啶方案联合自体CIK细胞输注治疗Ⅳ期胃癌的疗效与安全性研究

目的探讨紫杉醇、奥沙利铂、氟尿嘧啶方案联合自体细胞因子诱导杀伤细胞(CIK细胞)输注治疗Ⅳ期胃癌的临床疗效及安全性。方法回顾性分析我科2008年5月—2010年3月经组织学或细胞学证实的Ⅳ期胃癌患者34例,化疗方案:确认患者白细胞数≥8×109/L时进行自体CIK细胞采血,送入实验室进行CIK培养,第1天。紫杉醇135 mg/m2,第2天。氟尿嘧啶500 mg/m2,1次/d,化疗泵持续静脉滴注,第3～7天,奥沙利铂100 mg/m2静脉滴注,维持3 h,第3天。CIK实验室培养成熟后回输,第14天。21 d为1个周期,2个周期后评价疗效。结果本组34例患者总有效率为70.5%(24/34),其中完全缓解率为2.9%(1/34),部分缓解率为67.6%(23/34),稳定率为23.6%(8/34),疾病进展率为5.9%(2/34)。中位疾病进展时间为8.3个月,中位总生存时间为11.2个月。主要毒性反应为外周血细胞下降、脱发及外周神经毒性。结论应用紫杉醇、奥沙利铂、氟尿嘧啶方案联合自体CIK细胞输注治疗Ⅳ期胃癌,疗效显著,毒性反应较轻,治疗顺应性好,且提高了患者的生存质量,值得进一步推广。

Paclitaxel,Oxaliplatin,Fluorouracil Combined with Autologous CIK Cell Infusion in the Treatment of Advanced Gastric Cancer:A Retrospective Analysis

Objective To explore the safety profile and the clinical efficacy of paclitaxel,oxaliplatin,fluorouracil combined with autologous cytokine-induced killer(CIK) cell infusion in the treatment of advanced gastric cancer.Methods The clinical data of 34 patients in our department from May 2008 to March 2010 with histologically or cytologically confirmed advanced gastric cancer were retrospectively analyzed.CIK cells were collected when the patients′ white blood cell amounts were ≥8×109 /L,and then cultured in laboratory.The drugs were administered as follows:paclitaxel 135 mg/m2,d2,fluorouracil(5-Fu) 500 mg/d/m2,intravenous continuous infusion chemotherapy pump d3~7,and oxaliplatin 100 mg/m2,intravenously 3 h,d3 Matured CIK cell was reinfused,d14.Each cycle lasted 21 days,and two cycles were evaluated for each patient.Results The overall effective rate was 70.5%(24/34),which included complete response(2.9%,1/34),partial remission(67.6%,23/34),stable(23.6%,8/34),and progression(5.9%,2/34).The median time to progression was 8.3 months,and the median survival was 11.2 months.The main toxicities included decreased peripheral blood cells,alopecia,and peripheral neurotoxicity.Conclusion Paclitaxel,oxaliplatin,fluorouracil combined with autologous CIK cell infusion have shown good efficacy and toxicity profiles in the treatment of advanced gastric cancer.