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树突状细胞与细胞因子诱导的杀伤细胞联合免疫疗法治疗恶性肿瘤:一项系统评价与荟萃分析

Combined immunotherapy with dendritic cells and cytokine-induced killer cells for malignant tumors: a systematic review and meta-analysis.

作者信息

Chen Ran, Deng Xin, Wu Haochen, Peng Peichun, Wen Bin, Li Fuyin, Li Fenfen

机构信息

Department of Digestive, Ruikang Affiliated Hospital of Guangxi, University of Chinese Medicine, 530011 Huadong Road No. 10, Nanning, 530023 Guangxi, China.

Department of Digestive, Ruikang Affiliated Hospital of Guangxi, University of Chinese Medicine, 530011 Huadong Road No. 10, Nanning, 530023 Guangxi, China.

出版信息

Int Immunopharmacol. 2014 Oct;22(2):451-64. doi: 10.1016/j.intimp.2014.07.019. Epub 2014 Jul 27.

Abstract

PURPOSE

A new strategy of adoptive and passive immunotherapy involves combining dendritic cells (DCs) with a subset of natural killer T lymphocytes termed cytokine-induced killer (CIK) cells. The objective of this systematic review and meta-analysis was to evaluate the safety and efficacy of DC-CIK therapy vs. placebo, no intervention, conventional treatments, or other complementary and alternative medicines for malignant tumors.

METHOD

We searched PubMed, Medline, Embase, Cochrane, Wangfang, Weipu, CNKI databases and reference lists of articles. We selected randomized controlled trials of DC-CIK therapy vs. placebo, no intervention, conventional treatments, or other complementary and alternative medicines in patients with all types and stages of malignant tumor. Primary outcome measures were overall survival and treatment response. Secondary outcome measures were health-related quality of life (HRQoL) assessment, progression free survival (PFS), and adverse events.

RESULTS

Six trials met our inclusion criteria. There was evidence that chemotherapy+DC-CIK increased the 2-year (RR 2.88, 95% CI 1.38 to 5.99, P=0.005) and 3-year (RR 11.67, 95% CI 2.28 to 59.69, P=0.003) survival rates and progression free survival (RR 0.64, 95% CI 0.34 to 0.94, P<0.0001) in patients with non-small cell lung cancer compared to those treated with chemotherapy alone. DC-CIK therapy appears to be well-tolerated by cancer patients and to improve post-treatment patient health related quality of life.

CONCLUSION

DC-CIK immunotherapy is a safe and effective treatment for patients with malignant tumors. Further clinical trials to provide supportive evidence for the routine use of DC-CIK therapy in clinical practice are warranted.

摘要

目的

一种过继性和被动免疫治疗的新策略涉及将树突状细胞(DCs)与一类称为细胞因子诱导杀伤(CIK)细胞的自然杀伤T淋巴细胞亚群相结合。本系统评价和荟萃分析的目的是评估DC-CIK疗法与安慰剂、不干预、传统治疗或其他用于恶性肿瘤的补充和替代药物相比的安全性和有效性。

方法

我们检索了PubMed、Medline、Embase、Cochrane、万方、维普、中国知网数据库以及文章的参考文献列表。我们选择了在所有类型和分期的恶性肿瘤患者中比较DC-CIK疗法与安慰剂、不干预、传统治疗或其他补充和替代药物的随机对照试验。主要结局指标为总生存期和治疗反应。次要结局指标为健康相关生活质量(HRQoL)评估、无进展生存期(PFS)和不良事件。

结果

六项试验符合我们的纳入标准。有证据表明,与单纯接受化疗的患者相比,化疗联合DC-CIK可提高非小细胞肺癌患者的2年生存率(RR 2.88,95%CI 1.38至5.99,P=0.005)和3年生存率(RR 11.67,95%CI 2.28至59.69,P=0.003)以及无进展生存期(RR 0.64,95%CI 0.34至0.94,P<0.0001)。DC-CIK疗法似乎能被癌症患者很好地耐受,并能改善治疗后患者的健康相关生活质量。

结论

DC-CIK免疫疗法对恶性肿瘤患者是一种安全有效的治疗方法。有必要进行进一步的临床试验,为DC-CIK疗法在临床实践中的常规应用提供支持性证据。

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