Du Xiao-Hui, Liu Hai-Liang, Li Li, Xia Shao-You, Ning Ning, Zou Zhen-Yu, Teng Da, Xiao Chun-Hong, Li Rong, Xu Ying-Xin
General Surgery Institute, General Hospital of PLA, 28 Fuxing Road, Haidian District, Beijing, 100853, China.
Tumour Biol. 2015 Jul;36(7):5679-85. doi: 10.1007/s13277-015-3242-4. Epub 2015 Mar 13.
Surgery, chemotherapy, and radiotherapy have presented with the ability of killing tumor cells, as well as damaging the immune function, which can be corrected by the immunotherapy. The purpose of this perspective cohort study was to evaluate the efficacy of postoperative immunotherapies of tumor lysate-loaded dendritic cells (DC), in vitro DC-activated T (DC-AT), and activated T cells (ATC) combined with chemotherapy on the survival of patients with operable colorectal cancer. A total of 253 patients with primary colorectal cancer resection including 181 patients receiving postoperative simple chemotherapy (control group) and 72 patients receiving immunotherapies of DC, DC-AT, and ATC combined with chemotherapy during the corresponding period (immunotherapy group) were enrolled in this perspective cohort study. The survival of these patients was analyzed. The immunotherapy group presented a higher 5-year overall survival rate than the control group (75.63 vs 67.81 %, P = 0.035), as well as 3-year overall survival rate (87.07 vs 74.80 %, P = 0.045). For patients with advanced cancer (TNM stages III and IV), immunotherapy significantly promotes mean survival than control subjects (59.74 ± 3.21 vs 49.99 ± 2.54 years, P = 0.034). Patients who received more than three cycles of immunotherapies had a higher 5-year overall survival rate than those with less than three cycles (82.10 vs 69.90 %, P = 0.035). No serious adverse effect was observed in the immunotherapy group. Postoperative immunotherapies with DC, DC-AT, and ATC combination can promote the survival of patients with operable colorectal cancer (Clinical Trials, ChiCTR-OCH-12002610).
手术、化疗和放疗虽具备杀死肿瘤细胞的能力，但也会损害免疫功能，而免疫疗法可对此加以纠正。本前瞻性队列研究的目的是评估肿瘤裂解物负载树突状细胞（DC）、体外DC激活T细胞（DC-AT）以及激活T细胞（ATC）的术后免疫疗法联合化疗对可手术切除的结直肠癌患者生存的影响。本前瞻性队列研究共纳入253例原发性结直肠癌切除患者，其中181例患者术后接受单纯化疗（对照组），72例患者在相应时期接受DC、DC-AT和ATC联合化疗的免疫疗法（免疫治疗组）。分析了这些患者的生存情况。免疫治疗组的5年总生存率高于对照组（75.63%对67.81%，P = 0.035），3年总生存率也更高（87.07%对74.80%，P = 0.045）。对于晚期癌症（TNM分期III期和IV期）患者，免疫疗法显著提高了平均生存期，优于对照组（59.74±3.21年对49.99±2.54年，P = 0.034）。接受超过三个周期免疫疗法的患者5年总生存率高于接受少于三个周期的患者（82.10%对69.90%，P = 0.035）。免疫治疗组未观察到严重不良反应。DC、DC-AT和ATC联合的术后免疫疗法可提高可手术切除的结直肠癌患者的生存率（临床试验，ChiCTR-OCH-12002610）。
