Liu Yan, Mu Ying, Zhang Anqi, Ren Shaoda, Wang Weihua, Xie Jiaping, Zhang Yingxin, Zhou Changhui
Department of Gastroenterology, Weifang People's Hospital, Weifang.
Department of Gastroenterology.
Onco Targets Ther. 2017 Mar 29;10:1897-1908. doi: 10.2147/OTT.S132507. eCollection 2017.
Immunotherapy based on cytokine-induced killer cells or combination of dendritic cells and cytokine-induced killer cells (CIK/DC-CIK) showed promising clinical outcomes for treating esophageal cancer (EC). However, the clinical benefit varies among previous studies. Therefore, it is necessary to systematically evaluate the curative efficacy and safety of CIK/DC-CIK immunotherapy as an adjuvant therapy for conventional therapeutic strategies in the treatment of EC.
Clinical trials published before October 2016 and reporting CIK/DC-CIK immunotherapy treatment responses or safety for EC were searched in Cochrane Library, EMBASE, PubMed, Wanfang and China National Knowledge Internet databases. Research quality and heterogeneity were evaluated before analysis, and pooled analyses were performed using random- or fixed-effect models.
This research covered 11 trials including 994 EC patients. Results of this meta-analysis indicated that compared with conventional therapy, the combination of conventional therapy with CIK/DC-CIK immunotherapy significantly prolonged the 1-year overall survival (OS) rate, overall response rate (ORR) and disease control rate (DCR) (1-year OS: =0.0005; ORR and DCR: <0.00001). Patients with combination therapy also showed significantly improved quality of life (QoL) (=0.02). After CIK/DC-CIK immunotherapy, lymphocyte percentages of CD3 and CD3CD56 subsets (<0.01) and cytokines levels of IFN-γ, -2, TNF-α and IL-12 (<0.00001) were significantly increased, and the percentage of cluster of differentiation (CD)4CD25CD127 subset was significantly decreased, whereas analysis of CD4, CD8, CD4/CD8 and CD3CD56 did not show significant difference (>0.05).
The combination of CIK/DC-CIK immunotherapy and conventional therapy is safe and markedly prolongs survival time, enhances immune function and improves the treatment efficacy for EC.
基于细胞因子诱导的杀伤细胞或树突状细胞与细胞因子诱导的杀伤细胞联合应用（CIK/DC-CIK）的免疫疗法在治疗食管癌（EC）方面显示出了有前景的临床疗效。然而，以往研究中的临床获益存在差异。因此，有必要系统评估CIK/DC-CIK免疫疗法作为辅助治疗手段联合传统治疗策略用于EC治疗的疗效和安全性。
检索Cochrane图书馆、EMBASE、PubMed、万方和中国知网数据库中2016年10月之前发表的报告CIK/DC-CIK免疫疗法对EC治疗反应或安全性的临床试验。分析前评估研究质量和异质性，并使用随机或固定效应模型进行汇总分析。
本研究纳入11项试验，共994例EC患者。该荟萃分析结果表明，与传统疗法相比，传统疗法联合CIK/DC-CIK免疫疗法显著延长了1年总生存率（OS）、总缓解率（ORR）和疾病控制率（DCR）（1年OS：=0.0005；ORR和DCR：<0.00001）。联合治疗的患者生活质量（QoL）也显著改善（=0.02）。CIK/DC-CIK免疫治疗后，CD3和CD3CD56亚群的淋巴细胞百分比（<0.01）以及IFN-γ、-²、TNF-α和IL-12的细胞因子水平（<0.00001）显著升高，分化簇（CD）4CD25CD127亚群的百分比显著降低，而CD4、CD8、CD4/CD8和CD3CD56的分析未显示显著差异（>0.05）。
CIK/DC-CIK免疫疗法与传统疗法联合应用安全，可显著延长生存时间，增强免疫功能，提高EC的治疗效果。
