DC-CIK或CIK联合化疗治疗晚期非小细胞肺癌研究的Meta分析
Meta-analysis of DC-CIK or CIK combined with chemotherapy in the treatment of advanced non-small cell lung cancer
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摘要: 目的:对树突状细胞(DC)和细胞因子诱导的杀伤细胞(CIK)联合化疗治疗晚期非小细胞肺癌(NSCLC)的相关文献进行Meta分析,了解生物免疫治疗联合化疗治疗晚期NSCLC的临床疗效。方法:检索中文期刊数据库、维普数据库、万方数据库及PubMed、CBM等西文数据库,查找DC-CIK或CIK联合化疗治疗NSCLC的临床研究文献。采用Jadad评分量表对纳入文献进行质量评价,使用Revman 4.2统计软件对临床疗效、生活质量及免疫检测指标(CD3+、CD4+、CD4+/CD8+)进行Meta分析。结果:经筛选后纳入11篇随机对照临床试验文献,质量分析显示纳入文献质量不高。临床获益合并效应比值比(OR)为2.45,95%CI为1.56～3.83;生活质量合并效应量OR为3.17,95%CI为1.82～5.52;治疗后免疫学检测指标CD3+的合并效应量 OR为16.96,95%CI为14.09～17.82;CD4+的合并效应量 OR为6.84,95%CI为6.06～8.63;CD4+/CD8+的合并效应量OR为0.60,95%CI为0.56～0.65。DC-CIK或CIK联合化疗治疗NSCLC的临床获益率及生活质量明显优于对照组,治疗后免疫功能也优于对照组。结论:DC-CIK或CIK能明显提高晚期NSCLC患者的临床获益率及生活质量,并能提高化疗后患者免疫功能。Abstract: Objective: To study the clinical efficacy of biological immune therapy of dendritic cell(DC) or cytokine-induced killers cell(CIK) combined with chemotherapy in the treatment of advanced non-small cell lung cancer(NSCLC) by using Meta-analysis and systematic review of the literature.Methods: Randomized controlled trials(RCT) papers were searched in China Academic Journals,China National Knowledge Infrastructure,WeiPu and Wanfang database,PubMed and CBM foreign database.Jadad scale was used to devalue the quality of the included papers;Meta-analysis of the clinical efficacy,the life quality and the immunologic function(CD3+、CD4+、CD4+/CD8+) was performed with Revman 4.2 software.Results: Eleven RCT papers were included after screening,and the quality of the papers obtained low Jadad score.Meta-analysis showed that the odds ratio(OR) of the combined clinical benefit rate was 2.45,95% CI 1.56 to 3.83;the OR of the life quality was 3.17,95%CI 1.82 to 5.52.After treatment,the levels of CD3+ in the immunotherapy group increased to 16.96,95%CI 14.09 to 17.82,the levels of CD4+ increased to 6.84,95%CI 6.06 to 8.63 and the levels of CD4+/CD8+ increased to 0.60,95%CI 0.56 to 0.65.The clinical benefit rate and the immunologic function rate of the DC-CIK therapy or CIK combined with chemotherapy were superior to those of the control in the treatment of NSCLC.Conclusions: Biological immune therapy of DC-CIK or CIK combined with chemotherapy can help to improve the clinical benefit rate,the life quality and immunologic function of the patients with advanced NSCLC.
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Key words:
- carcinoma,non-small cell lung /
- biological immune therapy /
- dendritic cell /
- killers cell
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[1] 万德森.临床肿瘤学[M].北京:科技出版社,2002:156-158. [2] 李文,宋立强,刘吉福.自体CIK细胞过继免疫治疗晚期非小细胞肺癌的临床研究[J].陕西医学杂志,2010,39(2):163-164. [3] Ueda Y,Shimizu K,Itoh T,et al.Induction of peptide-specific immune response in patients with primary malignant melanoma of the esophagus after immunotherapy using dendritic cells pulsed with MAGE peptides[J].Jpn J Clin Oncol,2007,37(2):140-150. [4] 孙峰,鲍扬漪.CIK细胞联合化疗治疗晚期非小细胞肺癌临床观察[J].安徽医药,2012,16(7):1008-1010. [5] 杨莉莉,曹水,李慧,等.DC-CIK细胞联合化疗治疗晚期非小细胞肺癌临床疗效评价[J].中国肿瘤临床,2009,36(17):969-973. [6] 元建华,彭大为,李建旺.DC-CIK细胞联合化疗治疗晚期非小细胞肺癌近期疗效观察[J].临床肺科杂志,2011,16(12):1910-1911. [7] 何佳,李靖,莫明聪.DC-CIK细胞联合化疗治疗晚期非小细胞肺癌近期临床疗效[J].中国医学创新,2012,28(9):4-5. [8] 李冰,郑秋红.DC-CIK细胞联合化疗治疗晚期非小细胞肺癌临床探讨[J].黑龙江医学,2011,35(1):4-7. [9] 孙政,宋鑫,黄云超,等.NSCLC患者术后CIK细胞免疫治疗联合化疗疗效观察[J].云南医药,2011,32(6):576-580. [10] 李高峰,蒋永新,王巍炜,等.化疗联合免疫治疗与单纯化疗治疗中晚期非小细胞肺癌疗效分析[J].昆明医学院学报,2006,16(4):91-95. [11] 刘爱民,王学刚,张书,等.手术、化疗联合CIK细胞治疗晚期非小细胞肺癌的临床研究[J].中外医学研究,2009,8(7):30-31. [12] 杨轩璇,蒋敬庭,石亮荣,等.自体CIK细胞联合化疗治疗晚期非小细胞肺癌[J].临床研究,2008,28(2):237-240. [13] 田声望,蒋敬庭,石亮荣,等.自体CIK细胞治疗晚期非小细胞肺癌[J].江苏医药,2008,34(9):880-881. [14] 彭大为,李建旺,元建华,等.自体DC-CIK细胞联合培美曲塞治疗老年非小细胞肺癌的疗效与安全性[J].实用临床免疫学,2012,28(7):648-650. [15] Zhang JP,Mao GH,Han YP,et al.The clinical effects of DC-CIK cells combined with chemotherapy in the treatment of advanced NSCLC[J].Chinese-German J Clin Oncol,2012,11(2):67-71. [16] Fisher MD,D'Orazio A.PhaseⅡand Ⅲ trials:comparison of four chemotherapy regimens in advanced non small cell lung cancer(ECOG 1594) [J].Clin Lung Cancer,2000,2(1):21-22. -
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