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恶性间皮瘤患者免疫化疗成功:两例报告

Successful immunochemotherapy for patients with malignant mesothelioma: report of two cases.

作者信息

Tani M, Tanimura H, Yamaue H, Mizobata S, Yamamoto M, Iwahashi M, Ura K, Nagai Y, Tsunoda T, Wakasaki H, Nanjo K, Fujino K, Yukawa S

机构信息

Second Department of Surgery, Wakayama Medical School, Japan.

出版信息

Surg Today. 1998;28(6):647-51. doi: 10.1007/s005950050200.

Abstract

Malignant mesothelioma is a clinically aggressive tumor and has a poor prognosis; therefore, the selection of therapeutic strategies is important to improve the prognosis. Two patients with intraperitoneal malignant mesothelioma received combination therapy as follows: (1) case-oriented chemotherapy according to the results of a chemosensitivity test, and (2) adoptive immunotherapy using cytotoxic T lymphocytes (CTL). The chemosensitivity test was assessed by an MTT colorimetric assay. CTL was generated by a mixed culture with autologous tumor cells, and activated by immobilized anti-CD3 monoclonal antibody and interleukin-2. The MTT assay indicated that cisplatin and adriamycin were sensitive drugs in both patients, and they thus received the case-oriented chemotherapy according to the MTT assay. The activated CTL exhibited a high cytotoxicity against autologous malignant mesothelioma cells, and were transferred intraperitoneally. The patients were controllable for ascites, and the tumor masses gradually vanished (partial response). Chemoimmunotherapy is thus considered to be an effective treatment for intraperitoneal malignant mesothelioma, especially to improve the quality of life.

摘要

恶性间皮瘤是一种临床侵袭性肿瘤,预后较差;因此,选择治疗策略对于改善预后很重要。两名腹膜恶性间皮瘤患者接受了如下联合治疗:(1)根据化疗敏感性试验结果进行个体化化疗,以及(2)使用细胞毒性T淋巴细胞(CTL)进行过继性免疫治疗。化疗敏感性试验通过MTT比色法进行评估。CTL通过与自体肿瘤细胞混合培养产生,并通过固定化抗CD3单克隆抗体和白细胞介素-2激活。MTT试验表明顺铂和阿霉素在两名患者中均为敏感药物,因此他们根据MTT试验接受了个体化化疗。激活的CTL对自体恶性间皮瘤细胞表现出高细胞毒性,并通过腹腔内注射进行转移。患者的腹水得到控制,肿瘤肿块逐渐消失(部分缓解)。因此,化学免疫疗法被认为是治疗腹膜恶性间皮瘤的有效方法,尤其是对于改善生活质量。

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