细胞因子激活杀伤细胞心包腔灌注治疗恶性心包积液

目的比较心包腔内灌注细胞因子诱导杀伤细胞（cytokine-induced killers,CIKs）及常规化疗药物治疗恶性心包积液的有效性及安全性。方法合并恶性心包积液的晚期恶性肿瘤患者32例,随机分为CIKs治疗组和常规化疗组。CIKs治疗组12例,化疗组20例。常规血细胞分离机采血,诱导CIKs细胞;心包腔内置管引流后灌注CIKs细胞或化疗药物,以世界卫生组织（World Health Organization,WHO）标准评价疗效及副作用,以χ2检验组间差异。结果CIKs治疗组完全缓解（complete remission,CR）2例（16.7%）,部分缓解（partial remission,PR）5例（41.7%）,稳定（sta-ble disease,SD）2例（16.7%）,进展（progressive disease,PD）3例（25.0%）;化疗组CR 3例（15.0%）,PR 4例（20.0%）,SD 7例（35.0%）,PD 6例（30.0%）。CIKs治疗组临床有效率（clinical response rate,RR）58.4%,临床得益率（clinicalbenefit response,CBR）75.1%;化疗组RR 35.0%,CBR 70.0%,两组比较无统计学差异（P〉0.05）。CIKs治疗组除2例（16.7%）患者出现一过性发热症状以外,未见其他明显毒副反应;化疗组有Ⅱ-Ⅲ度消化道反应5例（40.0%）、骨髓抑制2例（10.0%）,两组均无治疗相关性死亡。结论CIKs心包腔内灌注可有效控制恶性心包积液,且副反应小,疗效与心包腔内化疗未见统计学差异。

Treatment of Refractory Malignant Pericardial Effusion by Perfusion of Cytokine-induced Killers in Pericardial Cavity

Objective To compare the effectiveness and safety of treatment of refractory malignant pericardial effusion by intra-pericardial cavity perfusion of cytokine-induced killers （CIKs） or conventional chemotherapy. Methods Thirty-two patients with advanced malignance were randomly divided into CIKs group （12 cases） and chemotherapy group （20 cases）. The blood cells were collected conventionally with blood cell separator and CIKs were induced. After intra-pericardial cavity catheterization, the CIKs or chemotherapy drug were perfused. The effectiveness and side effects were evaluated by the World Health Organization （WHO） criterion and X2 test was applied to estimate the statistic difference between two groups. Results In the CIKs group,2 cases （16. 7%） were in complete remission （CR）,5 （41.7%） in partial remission （PR） ,2 （16. 7%） in stable disease （SD） and 3 （25.0%） in progressive disease （PD）. In chemotherapy group, 3 cases （15.0%） were in CR,4 （20. 0%） in PR,7 （35.0%） in SD and 6 （30. 0%） in PD. The RR and clinical benefit response （CBR） was 58.4% and 75.1% in CIKs group,and 35.0% and 70. 0% in chemotherapy group respectively,which was not different between two groups （P〉0. 05）. In CIKs group, no serious side effect was observed except for 2 cases （16. 7~//oo） with fevers. In chemotherapy group, Ⅱ-Ⅲ grade gastrointestinal reaction （5 cases, 40. 0%） and bone marrow depression （2 eases,10. 0%） were observed. There was no treatment related death in the two groups. Conclusion CIKs perfusion in pericardial cavity can effectively control the refractory malignant pericardial effusion with minor side effect. The treatment efficacy is not different from that of chemotherapy.