树突状细胞联合细胞因子诱导杀伤细胞治疗术后恶性黑色素瘤的疗效分析

目的 探讨树突状细胞联合细胞因子诱导杀伤细胞(DC-CIK)在治疗术后恶性黑色素瘤(MM)的疗效以及安全性分析. 方法 收集经病理确诊的MM患者77例,分为治疗组37例和对照组40例.对照组进行单纯手术治疗,治疗组于手术后进行DC-CIK治疗.对2组患者进行生存随访,比较2组患者的生存期、免疫功能和生活质量改善情况,观察不良反应,并进行预后相关因素的单因素和多因素分析. 结果 治疗组和对照组的中位生存期分别为45和29月,治疗组的总生存期显著高于对照组(P=0.018);2组的无进展生存期差别无统计学意义(P=0.245).治疗组患者的免疫功能和生活质量均得到显著改善,仅2例发生不良反应,且未达3/4级.是否有淋巴结转移(P=0.008)、是否进行DC-CIK治疗(P=0.02)以及治疗疗程数(P=0.031)是影响MM预后的独立预后因子. 结论 DC-CIK细胞免疫治疗可延长MM患者的生存期,提高其免疫功能,改善其生活质量,治疗过程安全性高,无明显副作用;治疗疗程多于4次时,疗效更好.

Efficacy of Dendritic and Cytokine-Induced Killer Cells onPostoperative Patients with Malignant Melanoma

Objective To observe the efficacy and safety of the application of dendritic and cytokine-induced killer (DC-CIK) cells on postoperative patients with malignant melanoma.Methods A total of 77 patients with malignant melanoma were recruited from May 2004 to May 2013.DC-CIK therapy was given to 37 patients after surgery in the treatment group,whereas the other 40 patients in the control group only received surgical treatment.Follow-up was conducted for the patients in the two groups.Overall survival (OS),progression free survival (PFS),immunologic function,Karnofsky performance status (KPS),and adverse reactions were compared.Univariate and multivariate analysis of survival were also carried out.Results The median OS was 45 months in the DC-CIK group and 29 months in the control group.The OS in the DC-CIK group was higher than that in the control group (P=0.018),while there was no significant difference in PFS between the two groups (P=0.245).However the immune function and quality of life were significantly improved for the DC-CIK group (P＜0.05) and only two patients in DC-CIK group had adverse reactions,which were less than grade 3/4.Multivariate analysis showed that lymph node metastasis (P=0.008),DC-CIK therapy (P=0.02),and DC-CIK therapy cycle (P=0.031) were independent prognostic parameters.Conclusion DC-CIK cell immunotherapy may prolong the survival of malignant melanoma patients and is safe and with tolerable adverse reactions.It can improve immune function and the quality of life of patients with malignant melanoma.If a patient received more than 4 DC-CIK cycles,it might produce greater clinical benefits.