多种过继性细胞免疫联合替吉奥治疗老年晚期胃癌患者的临床研究

Multicellular adoptive immunotherapy combined with S-1 in the elderly patients with advanced gastric cancer

摘要:

目的  探讨多种过继性细胞免疫（ACI）联合替吉奥治疗老年晚期胃癌患者的近期疗效，观察两组的有效性、安全性及患者的生活质量。方法  选取该院32例初治为晚期胃癌的老年患者，按照拟定的纳入及排除标准，采用随机数字表法随机分为两组：联合治疗组（多种ACI联合替吉奥治疗）和对照组（单用替吉奥）。通过影像学、实验室检查结果观察临床疗效、患者生活质量改善状况及毒性反应。结果  老年晚期胃癌患者应用联合组的中位无进展生存期（PFS）为4.7个月，对照组的中位PFS为3.9个月，差异有统计学意义（P <0.05）。联合治疗组改善失眠、乏力、食欲等的效果优于对照组，可显著改善患者生活质量。联合组与对照组的不良反应比较，仅增加发生率极低的发热症状，安全性高。结论  多种ACI联合替吉奥治疗老年晚期胃癌患者的中位PFS较单独应用替吉奥患者明显延长，疾病控制率和有效率提高，患者的生活质量明显提高，毒性反应更低、更安全，免疫力也显著提高。

Abstract:

Objective To explore the recent treatment effect and toxicity of multicellular adoptive immunotherapy combined with S-1 in the elderly advanced gastric cancer patients, and compare the difference in the therapeutic effect between multicellular adoptive immunotherapy combined with S-1 and S-1 used alone. Methods Thirty-two elderly patients who were diagnosed as advanced gastric cancer in our hospital were selected. The patients were randomly divided into two groups. The combined treatment group used multicellular adoptive immunotherapy combined with S-1, while the control group used S-1 alone. The clinical therapeutic effect was observed through imaging and laboratory results. The median progression-free survival (PFS), the patients' quality of life, the toxicity and immunity were observed. Results The median progression-free survival in the combined treatment group and the control group was 4.7 months and 3.9 months respectively, the difference was statistically significant (P < 0.05). Multicellular adoptive immunotherapy in combination with S-1 therapy significantly improved the patients' quality of life, especially for insomnia, fatigue and stomachic effect. Comaring the adverse reactions of both groups, the combined treatment group only had additional fever with lower incidence. The combined treatment had high safety compared to S-1 alone. Conclusions Compared with the therapy of S-1 alone, multicellular adoptive immunotherapy combined with S-1 has significant efficacy and low toxicity for the treatment of advanced gastric cancer in elderly patients, can prolong their progression-free survival, and improve the patients' quality of life and immunity.