自体细胞因子诱导的杀伤细胞治疗对辅助化疗后乳腺癌患者生活质量影响的前瞻性研究
자체세포인자유도적살상세포치료대보조화료후유선암환자생활질량영향적전첨성연구
Autologous cytokine-induced killer cells therapy on the quality of life of patients with breast cancer after adjuvant chemotherapy: A prospective study
  • 万方数据
    中华肿瘤杂志 중화종류잡지
    CHINESE JOURNAL OF ONCOLOGY
    2013年 10期 764-768 ,共5页

    梁雪峰%马东初%丁震宇%刘兆喆%郭放%刘良%于卉影%韩雅玲%谢晓冬

    량설봉%마동초%정진우%류조철%곽방%류량%우훼영%한아령%사효동

    乳腺肿瘤%生活质量%肿瘤辅助疗法%细胞因子诱导的杀伤细胞 乳腺腫瘤%生活質量%腫瘤輔助療法%細胞因子誘導的殺傷細胞
    유선종류%생활질량%종류보조요법%세포인자유도적살상세포
    Breast neoplasms%Quality of life%Neoadjuvant therapy%Cytokine-induced killer
    目的 探讨自体细胞因子诱导的杀伤细胞(CIK)治疗对辅助化疗后乳腺癌患者生活质量的影响.方法 将给予以紫杉或蒽环类药物为基础的辅助化疗的乳腺癌术后患者,采用随机数字表法随机分为治疗组和对照组,治疗组给予自体CIK细胞治疗,对照组进行定期随访.所有激素受体阳性的患者均给予内分泌治疗,腋窝淋巴结转移阳性的患者行胸壁和区域淋巴结放疗.采用欧洲癌症研究和治疗组(EORTC)制定的乳腺癌患者生活质量量表QLQ-BR53分析患者的生活质量和不良反应.结果 功能领域方面,治疗组患者在CIK细胞治疗后3和6个月躯体功能评分分别为(83.43±14.87)分和(88.55 ±11.62)分,均高于基线值[(74.83±13.82)分,均P＜0.05)]；总生活质量评分分别为(83.30±19.09)分和(89.68-10.81)分,均高于基线值[(77.72±21.05)分,均P＜0.05].症状领域方面,治疗组患者的疲倦和恶心呕吐评分与基线值比较,差异均有统计学意义(均P＜0.05).对照组患者在随访3和6个月时,恶心呕吐评分分别为(26.67±22.56)分和(21.47±21.06)分,均低于基线值[(33.31 ±27.07)分,均P＜0.05].治疗组患者在CIK细胞治疗后3和6个月对未来担忧评分分别为(47.56 ±30.84)分和(42.33±26.95)分,均低于基线值[(57.41 ±30.63)分,均P＜0.05)]；治疗副反应评分分别为(31.95±27.52)分和(23.72±22.87)分,均低于基线值[(40.56±26.28)分,均P＜0.05)]；上肢肿胀评分分别为(45.26±25.42)分和(36.61±20.51)分,均低于基线值[(55.11 ±22.82)分,均P＜0.05)].对照组患者在随访3和6个月时,上肢肿胀评分分别为(44.85 ±28.94)分和(38.64 ±23.68)分,均低于基线值[(53.26±23.84)分,均P＜0.05]；在随访6个月时,脱发评分为(24.18±22.66)分,低于基线值[(35.92±22.08)分,P＜0.05].治疗组患者的躯体功能、社会功能和总生活质量、疲倦、失眠和对未来担忧情况评分与对照组比较,差异均有统计学意义(均P＜0.05).治疗组患者回输CIK后,出现一过性发热3例,下肢酸胀疼痛6例,对症处理后症状均缓解.结论 自体CIK细胞治疗能显著改善乳腺癌患者的生活质量,治疗相关性不良反应可耐受,对症处理后缓解,可在临床上推广使用.
    목적 탐토자체세포인자유도적살상세포(CIK)치료대보조화료후유선암환자생활질량적영향.방법 장급여이자삼혹은배류약물위기출적보조화료적유선암술후환자,채용수궤수자표법수궤분위치료조화대조조,치료조급여자체CIK세포치료,대조조진행정기수방.소유격소수체양성적환자균급여내분비치료,액와림파결전이양성적환자행흉벽화구역림파결방료.채용구주암증연구화치료조(EORTC)제정적유선암환자생활질량량표QLQ-BR53분석환자적생활질량화불량반응.결과 공능영역방면,치료조환자재CIK세포치료후3화6개월구체공능평분분별위(83.43±14.87)분화(88.55 ±11.62)분,균고우기선치[(74.83±13.82)분,균P＜0.05)]；총생활질량평분분별위(83.30±19.09)분화(89.68-10.81)분,균고우기선치[(77.72±21.05)분,균P＜0.05].증상영역방면,치료조환자적피권화악심구토평분여기선치비교,차이균유통계학의의(균P＜0.05).대조조환자재수방3화6개월시,악심구토평분분별위(26.67±22.56)분화(21.47±21.06)분,균저우기선치[(33.31 ±27.07)분,균P＜0.05].치료조환자재CIK세포치료후3화6개월대미래담우평분분별위(47.56 ±30.84)분화(42.33±26.95)분,균저우기선치[(57.41 ±30.63)분,균P＜0.05)]；치료부반응평분분별위(31.95±27.52)분화(23.72±22.87)분,균저우기선치[(40.56±26.28)분,균P＜0.05)]；상지종창평분분별위(45.26±25.42)분화(36.61±20.51)분,균저우기선치[(55.11 ±22.82)분,균P＜0.05)].대조조환자재수방3화6개월시,상지종창평분분별위(44.85 ±28.94)분화(38.64 ±23.68)분,균저우기선치[(53.26±23.84)분,균P＜0.05]；재수방6개월시,탈발평분위(24.18±22.66)분,저우기선치[(35.92±22.08)분,P＜0.05].치료조환자적구체공능、사회공능화총생활질량、피권、실면화대미래담우정황평분여대조조비교,차이균유통계학의의(균P＜0.05).치료조환자회수CIK후,출현일과성발열3례,하지산창동통6례,대증처리후증상균완해.결론 자체CIK세포치료능현저개선유선암환자적생활질량,치료상관성불량반응가내수,대증처리후완해,가재림상상추엄사용.
    Objective To explore the effect of autologous cytokine-induced killer cells on the quality of life in patient with breast cancer who have already finished the adjuvant chemotherapy.Methods One hundred and twenty-eight postoperative patients with breast cancer who underwent anthracycline-based adjuvant chemotherapy were enrolled in this prospective study,and they were randomized into 2 groups,i.e.,treatment group,which received the therapy of CIK cells transfusion,and control group,which was given regular follow-up.Meanwhile,patients with positive hormone receptor in the two groups were given endocrine therapy,and the patients with positive axillary lymph nodes were given radiotherapy to the chest wall and regional lymph nodes.The difference of quality of life between the two groups was analyzed according to the EORTC QLQ-BR53 quality of life questionnaire,and the adverse reactions were monitored.Results As regarding the functional evaluation,the physical function scores of patients of the treatment group were (83.43 ± 14.87) and (88.55 ± 11.62) at 3 and 6 months after the CIK cell therapy,respectively,significantly higher than the baseline value [(74.83 ± 13.82),P ＜ 0.05)].Global health status/QOL scores were (83.30 ± 19.09) and (89.68 ± 10.81),significantly higher than the baseline value [(77.72 ±21.05),P ＜0.05].As regarding symptoms,the scores of fatigue,nausea,vomiting and loss of appetite of patients in the treatment group were higher than the baseline value,with significant differences (P ＜0.05).The nausea and vomiting scores in the control group at 3 and 6 months of followedup were (26.67 ± 22.56) and (21.47 ± 21.06),significantly lower than the baseline values [(33.31 ±27.07),P ＜ 0.05].The scores of worrying about the future in the patients of treatment group were (47.56 ± 30.84) and (42.33 ±26.95) after 3 and 6 months,significantly better than the baseline value [(57.41 ±30.63),P ＜0.05].The systematic therapy side effects scores were (31.95 ±27.52) and (23.72 ±22.87),significantly better than the baseline value [(40.56 ± 26.28),P ＜ 0.05].The scores of arm edema were (45.26 ±25.42) and (36.61 ±20.51),signbificantly milder than the baseline value [(55.11 ±22.82),P ＜ 0.05].In the control group,the scores of arm edema were (44.85 ± 28.94) and (38.64 ± 23.68),significantly lower than the baseline values [(53.26 ± 23.84) points,P ＜ 0.05].Alopecia scores were (29.93 ± 24.72) and (24.18 ± 22.66),significantly lower than the baseline values [(35.92 ± 22.08),P ＜ 0.05].In the treatment group,the patients' physical function,social function and global health status/ QOL,fatigue,insomnia,and worrying about the future rates were significantly higher than that of the control group (P ＜0.05 for all).Three patients after CIK reinfusion had transient fever,and 6 cases felt pain in the lower limb,but the symptoms were relieved after symptomatic treatment.Conclusions Therapy of autologous CIK cells transfusion can significantly improve the quality of life of breast cancer patients,and the adverse reactions during the treatment can be alleviated by symptomatic treatment.
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