背景与目的中晚期非小细胞肺癌(non-small celllung cancer,NSCLC)的治疗效果较差,生存期也较短,临床研究显示化疗与热疗的联合疗法效果较好。本研究通过系统评价吉西他滨联合铂类(Gemcitabine and Cis-platin,GP)或紫杉醇联合铂类(Pacl...背景与目的中晚期非小细胞肺癌(non-small celllung cancer,NSCLC)的治疗效果较差,生存期也较短,临床研究显示化疗与热疗的联合疗法效果较好。本研究通过系统评价吉西他滨联合铂类(Gemcitabine and Cis-platin,GP)或紫杉醇联合铂类(Paclitaxel and Cisplatin,TP)方案化疗联合热疗治疗NSCLC的疗效及安全性,为临床实践与研究提供参考。方法计算机检索Cochrane Library、PubMed、EMBASE和中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊数据库、数字化期刊全文数据库,同时辅以其它检索。收集所有比较GP或TP化疗联合热疗与单纯GP或TP化疗的随机对照试验(randomized controlled trial,RCT)。选择适当的质量评价标准对纳入文献进行质量评价,使用RevMan5.1软件进行meta分析。结果共纳入15篇RCT,共952例NSCLC。Meta分析结果显示,化疗联合热疗组的生活质量改善率(OR=3.84,95%CI:2.61-5.64)、1年生存率(HR=1.94,95%CI:1.21-3.12)和2年生存率(HR=2.05,95%CI:1.18-3.58)均好于单纯化疗组,差异均有统计学意义(P<0.05);热化组与单化组的骨髓抑制、胃肠反应、肝肾损害以及腹泻发生率的差异均无统计学意义(P>0.05)。结论相较于单纯化疗,GP或TP方案化疗联合热疗能提高中晚期NSCLC患者生存率和近期疗效,改善症状,提高患者的生活质量,且并不增加毒副反应,但本文结论尚需大样本高质量RCT进一步验证。展开更多
AIM:To study the effect and tolerance of intraperitoneal perfusion of cytokine-induced killer(CIK) cells in combination with local radio frequency(RF) hyperthermia in patients with advanced primary hepatocellular carc...AIM:To study the effect and tolerance of intraperitoneal perfusion of cytokine-induced killer(CIK) cells in combination with local radio frequency(RF) hyperthermia in patients with advanced primary hepatocellular carcinoma(HCC).METHODS:Patients with advanced primary HCC were included in this study.CIK cells were perfused intraperitoneal twice a week,using 3.2 × 10 9 to 3.6 × 10 9 cells each session.Local RF hyperthermia was performed 2 h after intraperitoneal perfusion.Following an interval of one month,the next course of treatment was administered.Patients received treatment until disease progression.Tumor size,immune indices(CD3 +,CD4 +,CD3 + CD8 +,CD3 + CD56 +),alpha-fetoprotein(AFP) level,abdominal circumference and adverse events were recorded.Time to progression and overall survival(OS) were calculated.RESULTS:From June 2010 to July 2011,31 patients diagnosed with advanced primary HCC received intraperitoneal perfusion of CIK cells in combination with local RF hyperthermia in our study.Patients received an average of 4.2 ± 0.6 treatment courses(range,1-8 courses).Patients were followed up for 8.3 ± 0.7 mo(range,2-12 mo).Following combination treatment,CD4 +,CD3 + CD8 + and CD3 + CD56 + cells increased from 35.78% ± 3.51%,24.61% ± 4.19% and 5.94% ± 0.87% to 45.83% ± 2.48%(P = 0.016),39.67% ± 3.38%(P = 0.008) and 10.72% ± 0.67%(P = 0.001),respectively.AFP decreased from 167.67 ± 22.44 to 99.89 ± 22.05 ng/mL(P = 0.001) and abdominal circumference decreased from 97.50 ± 3.45 cm to 87.17 ± 4.40 cm(P = 0.002).The disease control rate was 67.7%.The most common adverse events were low fever and slight abdominal erubescence,which resolved without treatment.The median time to progression was 6.1 mo.The 3-,6-and 9-mo and 1-year survival rates were 93.5%,77.4%,41.9% and 17.4%,respectively.The median OS was 8.5 mo.CONCLUSION:Intraperitoneal perfusion of CIK cells in combination with local RF hyperthermia is safe,can efficiently improve immunological status,and may prolong survival in HCC patients.展开更多
热疗是继手术、放疗、化疗及生物治疗之后的第5种肿瘤治疗手段,亦是重要的肿瘤辅助治疗方法之一,临床应用无毒、安全,被称为绿色治疗。近年来,肿瘤的热疗越来越受到重视,全国许多地市级医院甚至县级医院都普遍开展肿瘤热疗,并取得很好...热疗是继手术、放疗、化疗及生物治疗之后的第5种肿瘤治疗手段,亦是重要的肿瘤辅助治疗方法之一,临床应用无毒、安全,被称为绿色治疗。近年来,肿瘤的热疗越来越受到重视,全国许多地市级医院甚至县级医院都普遍开展肿瘤热疗,并取得很好的治疗效果。2017年中国制定第1版热疗指南,为热疗工作的开展提供标准和方向。时隔2年,中国临床肿瘤学会(Chinese Society of Clinical Oncology,CSCO)热疗专家委员会根据新的证据,在适应证、禁忌证和操作程序等方面,在原指南的基础上进行再次修订,期望修订后的共识能给热疗工作者带来更多规范化的指导,更好地为肿瘤患者服务。展开更多
文摘背景与目的中晚期非小细胞肺癌(non-small celllung cancer,NSCLC)的治疗效果较差,生存期也较短,临床研究显示化疗与热疗的联合疗法效果较好。本研究通过系统评价吉西他滨联合铂类(Gemcitabine and Cis-platin,GP)或紫杉醇联合铂类(Paclitaxel and Cisplatin,TP)方案化疗联合热疗治疗NSCLC的疗效及安全性,为临床实践与研究提供参考。方法计算机检索Cochrane Library、PubMed、EMBASE和中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊数据库、数字化期刊全文数据库,同时辅以其它检索。收集所有比较GP或TP化疗联合热疗与单纯GP或TP化疗的随机对照试验(randomized controlled trial,RCT)。选择适当的质量评价标准对纳入文献进行质量评价,使用RevMan5.1软件进行meta分析。结果共纳入15篇RCT,共952例NSCLC。Meta分析结果显示,化疗联合热疗组的生活质量改善率(OR=3.84,95%CI:2.61-5.64)、1年生存率(HR=1.94,95%CI:1.21-3.12)和2年生存率(HR=2.05,95%CI:1.18-3.58)均好于单纯化疗组,差异均有统计学意义(P<0.05);热化组与单化组的骨髓抑制、胃肠反应、肝肾损害以及腹泻发生率的差异均无统计学意义(P>0.05)。结论相较于单纯化疗,GP或TP方案化疗联合热疗能提高中晚期NSCLC患者生存率和近期疗效,改善症状,提高患者的生活质量,且并不增加毒副反应,但本文结论尚需大样本高质量RCT进一步验证。
基金Supported by The National Natural Science Foundation of China,No.81273814
文摘AIM:To study the effect and tolerance of intraperitoneal perfusion of cytokine-induced killer(CIK) cells in combination with local radio frequency(RF) hyperthermia in patients with advanced primary hepatocellular carcinoma(HCC).METHODS:Patients with advanced primary HCC were included in this study.CIK cells were perfused intraperitoneal twice a week,using 3.2 × 10 9 to 3.6 × 10 9 cells each session.Local RF hyperthermia was performed 2 h after intraperitoneal perfusion.Following an interval of one month,the next course of treatment was administered.Patients received treatment until disease progression.Tumor size,immune indices(CD3 +,CD4 +,CD3 + CD8 +,CD3 + CD56 +),alpha-fetoprotein(AFP) level,abdominal circumference and adverse events were recorded.Time to progression and overall survival(OS) were calculated.RESULTS:From June 2010 to July 2011,31 patients diagnosed with advanced primary HCC received intraperitoneal perfusion of CIK cells in combination with local RF hyperthermia in our study.Patients received an average of 4.2 ± 0.6 treatment courses(range,1-8 courses).Patients were followed up for 8.3 ± 0.7 mo(range,2-12 mo).Following combination treatment,CD4 +,CD3 + CD8 + and CD3 + CD56 + cells increased from 35.78% ± 3.51%,24.61% ± 4.19% and 5.94% ± 0.87% to 45.83% ± 2.48%(P = 0.016),39.67% ± 3.38%(P = 0.008) and 10.72% ± 0.67%(P = 0.001),respectively.AFP decreased from 167.67 ± 22.44 to 99.89 ± 22.05 ng/mL(P = 0.001) and abdominal circumference decreased from 97.50 ± 3.45 cm to 87.17 ± 4.40 cm(P = 0.002).The disease control rate was 67.7%.The most common adverse events were low fever and slight abdominal erubescence,which resolved without treatment.The median time to progression was 6.1 mo.The 3-,6-and 9-mo and 1-year survival rates were 93.5%,77.4%,41.9% and 17.4%,respectively.The median OS was 8.5 mo.CONCLUSION:Intraperitoneal perfusion of CIK cells in combination with local RF hyperthermia is safe,can efficiently improve immunological status,and may prolong survival in HCC patients.
文摘热疗是继手术、放疗、化疗及生物治疗之后的第5种肿瘤治疗手段,亦是重要的肿瘤辅助治疗方法之一,临床应用无毒、安全,被称为绿色治疗。近年来,肿瘤的热疗越来越受到重视,全国许多地市级医院甚至县级医院都普遍开展肿瘤热疗,并取得很好的治疗效果。2017年中国制定第1版热疗指南,为热疗工作的开展提供标准和方向。时隔2年,中国临床肿瘤学会(Chinese Society of Clinical Oncology,CSCO)热疗专家委员会根据新的证据,在适应证、禁忌证和操作程序等方面,在原指南的基础上进行再次修订,期望修订后的共识能给热疗工作者带来更多规范化的指导,更好地为肿瘤患者服务。
