切换至 "中华医学电子期刊资源库"

中华乳腺病杂志(电子版) ›› 2014, Vol. 08 ›› Issue (01) : 26 -30. doi: 10.3877/cma.j.issn.1674-0807.2014.01.006

论著

冷冻联合免疫疗法治疗无法手术的转移性乳腺癌
周亮1, 姚飞1, 陈继冰1, 曾健滢1, 汪媛1, 李家亮1,(), 牛立志1, 徐克成1   
  1. 1.510665 广州,暨南大学医学院附属广州复大肿瘤医院肿瘤一科
  • 收稿日期:2013-10-09 出版日期:2014-02-01
  • 通信作者: 李家亮

Cryotherapy combined with immunotherapy for inoperable metastatic breast cancer

Liang Zhou1, Fei Yao1, Jibing Chen1, Jianying Zeng1, Yuan Wang1, Jialiang Li1,(), Lizhi Niu1, Kecheng Xu1   

  1. 1.Department of Oncology, Fuda Cancer Hospital Affiliated to Jinan University School of Medicine, Guangzhou 510665, China
  • Received:2013-10-09 Published:2014-02-01
  • Corresponding author: Jialiang Li
引用本文:

周亮, 姚飞, 陈继冰, 曾健滢, 汪媛, 李家亮, 牛立志, 徐克成. 冷冻联合免疫疗法治疗无法手术的转移性乳腺癌[J]. 中华乳腺病杂志(电子版), 2014, 08(01): 26-30.

Liang Zhou, Fei Yao, Jibing Chen, Jianying Zeng, Yuan Wang, Jialiang Li, Lizhi Niu, Kecheng Xu. Cryotherapy combined with immunotherapy for inoperable metastatic breast cancer[J]. Chinese Journal of Breast Disease(Electronic Edition), 2014, 08(01): 26-30.

目的

研究冷冻联合DC-CIK(dendritic cell-cytokine-induced killer)免疫疗法治疗转移性乳腺癌的疗效。

方法

回顾性分析2002 年5 月至2012 年5 月本院收治的120 例转移性乳腺癌患者(共计222 个转移灶)的临床资料,其中35 例患者接受冷冻联合DC-CIK 免疫疗法治疗(冷冻联合免疫疗法组),29 例患者接受冷冻联合化疗(冷冻联合化疗组),27 例患者接受冷冻治疗(冷冻治疗组),29 例患者接受化疗(化疗组)。在27 例仅接受冷冻治疗的患者中,有18 例患者接受单次冷冻治疗,9 例患者接受多次冷冻治疗。对所有患者进行定期随访,总生存期以诊断为转移性乳腺癌时开始计算。采用单因素方差分析、Kruskal-Wallis 检验和Friedman 检验比较患者的一般情况。采用Kaplan-Meier 法绘制生存曲线,各组患者总生存期的比较采用Log-rank 检验。

结果

冷冻联合免疫疗法组中位生存期为83(69.5 ~113.0)个月,冷冻联合化疗组中位生存期为48(30.0 ~64.0)个月,冷冻治疗组中位生存期为43(30.5 ~53.0)个月,化疗组中位生存期为27(18.0 ~41.0)个月,4 组间差异有统计学意义(χ2 =20.30,P=0.000);其中,冷冻联合免疫疗法组总生存期显著长于冷冻联合化疗组、冷冻治疗组和化疗组(χ2 =27.58,P=0.000;χ2=27.76,P=0.000;χ2=74.21, P=0.000)。在冷冻治疗组中,多次冷冻组与单次冷冻组的中位生存期分别为54(37.0 ~67.0)个月和35(28.0 ~48.5)个月,多次冷冻组总生存期显著长于单次冷冻组(χ2=6.25,P=0.012)。各组乳腺癌患者均未发生严重的术后并发症。

结论

冷冻联合免疫疗法能显著延长无法手术的转移性乳腺癌患者的总生存期。

Objective

To investigate the efficacy of cryotherapy plus dendritic cell-cytokine-induced killer (DC-CIK) immunotherapy for metastatic breast cancer.

Methods

We retrospectively analyzed the clinical data of 120 patients with metastatic breast cancer (a total of 222 lesions) in Fuda Cancer Hospital from May 2002 to May 2012.In all patients, 35 patients received cryotherapy plus DC-CIK immunotherapy(cryotherapy plus immunotherapy group), 29 received cryotherapy plus chemotherapy (cryotherapy plus chemotherapy group), 27 patients received cryotherapy (cryotherapy group: 18 patients underwent single therapy and the other 9 underwent multiple therapies) and 29 patients received chemotherapy (chemotherapy group).All patients were followed up.Overall survival (OS) was started from diagnosis time of metastatic breast cancer and analyzed by Log-rank test.The one-way ANOVA, Kruskal-Wallis test and Friedman test were used to compare the general data.Survival curve was drawn using Kaplan-Meier method.

Results

The median survival was 83 months (69.5-113.0 months) in cryotherapy plus immunotherapy group, 48 months (30.0-64.0 months) in cryotherapy plus chemotherapy group,43 months (30.5-53.0 months) in cryotherapy group and 27 months (18.0 -41.0 months) in chemotherapy group.The difference in median survival were statistically significant(χ2 = 20.30, P = 0.000).The OS in cryotherapy plus immunotherapy group was significantly higher than that in cryotherapy plus chemotherapy group, cryotherapy group or chemotherapy group(χ2=27.58,P = 0.000;χ2 = 27.76,P = 0.000;χ2 = 74.21, P = 0.000).In the patients only receiving cryotherapy, the median survival in multiple therapy group was 54 months (37.0-67.0 months), significantly higher than 35 months(28.0-48.5 months)in single therapy group(χ2 = 6.25,P = 0.012).No serious postoperative complications were found in the four groups.

Conclusion

Cryotherapy combined with immunotherapy can increase the OS in inoperable metastatic breast cancer patients.

表1 各组乳腺癌患者的一般临床资料比较
表2 各组乳腺癌患者的转移灶部位比较(个)
图1 乳腺癌患者肺部转移灶冷冻后的CT 扫描图
图2 各组乳腺癌患者的Kaplan-Meier 生存曲线比较 冷冻联合免疫疗法组总生存期显著长于冷冻联合化疗组(χ2=27.58,P=0.000)、冷冻治疗组(χ2 =27.76,P=0.000)和化疗组(χ2=74.21, P=0.000)
图3 多次冷冻组与单次冷冻组乳腺癌患者的Kaplan-Meier 生存曲线比较 P=0.012,多次冷冻组(9 例)与单次冷冻治疗组(18 例)比较(log-rank 检验,χ2=6.25)
[1]
DeSantis C, Ma J, Bryan L, et al.Breast cancer statistics,2013[J].CA Cancer J Clin,2014,64(1):52-62.
[2]
Andre F, Slimane K, Bachelot T, et al.Breast cancer with synchronous metastases: trends in survival during a 14-year period[J].J Clin Oncol,2004,22(16):3302-3308.
[3]
Chia SK, Speers CH, D’Yachkova Y, et al.The impact of new chemotherapeutic and hormone agents on survival in a population-based cohort of women with metastatic breast cancer[J].Cancer,2007,110(5):973-979.
[4]
Pusceddu C, Capobianco G, Meloni F, et al.CT-guided cryoablation of both breast cancer and lymph node axillary metastasis[J].Eur J Gynaecol Oncol,2011,32(2):224-225.
[5]
Niu L, Chen J, Yao F, et al.Percutaneous cryoablation for stage Ⅳlung cancer:a retrospective analysis[J].Cryobiology,2013,67(2):151-155.
[6]
Mu F, Niu L, Li H, et al.Percutaneous comprehensive cryoablation for metastatic hepatocellular cancer[J].Cryobiology,2013,66(1):76-80.
[7]
Kapoor A, Touma NJ, Dib RE.Review of the efficacy and safety of cryoablation for the treatment of small renal masses[J].Can Urol Assoc J,2013,7(1/2):E38-44.
[8]
Bomers JG,Yakar D, Overduin CG, et al.MR imaging-guided focal cryoablation in patients with recurrent prostate cancer[J].Radiology,2013,268(2):451-460.
[9]
Kalinski P, Edington H, Zeh HJ, et al.Dendritic cells in cancer immunotherapy: vaccines or autologous transplants?[J].Immunol Res,2011,50(2/3):235-247.
[10]
Hontscha C, Borck Y, Zhou H, et al.Clinical trials on CIK cells: first report of the international registry on CIK cells(IRCC)[J].J Cancer Res Clin Oncol,2011,137(2):305-310.
[11]
Chen AP, Setser A, Anadkat MJ, et al.Grading dermatologic adverse events of cancer treatments: the Common Terminology Criteria for Adverse Events Version 4.0 [J].J Am Acad Dermatol,2012,67(5):1025-1039.
[12]
Tichy JR, Lim E, Anders CK.Breast cancer in adolescents and young adults: a review with a focus on biology[J].J Natl Compr Canc Netw,2013,11(9):1060-1069.
[13]
Li XD, Xu B,Wu J,et al.Review of Chinese clinical trials on CIK cell treatment for malignancies[J].Clin Transl Oncol,2012,14(2):102-108.
[14]
Thanendrarajan S, Nowak M, Abken H, et al.Combining cytokine-induced killer cells with vaccination in cancer immunotherapy: more than one plus one? [J].Leuk Res,2011,35(9):1136-1142.
[15]
Plate J.Clinical trials of vaccines for immunotherapy in pancreatic cancer[J].Expert Rev Vaccines,2011, 10(6):825-836.
[16]
Sabel MS.Cryo-immunology: a review of the literature and proposed mechanisms for stimulatory versus suppressive immune responses[J].Cryobiology,2009,58(1):1-11.
[17]
Schnurr M, Scholz C, Rothenfusser S, et al.Apoptotic pancreatic tumor cells are superior to cell lysates in promoting cross-priming of cytotoxic T cells and activate NK and gammadelta T cells[J].Cancer Res,2002,62(8):2347-2352.
[18]
Rovere-Querini P, Manfredi AA.Tumor destruction and in situ delivery of antigen presenting cells promote anti-neoplastic immune responses: implications for the immunotherapy of pancreatic cancer[J].JOP,2004,5(4):308-314.
[1] 李洋, 蔡金玉, 党晓智, 常婉英, 巨艳, 高毅, 宋宏萍. 基于深度学习的乳腺超声应变弹性图像生成模型的应用研究[J]. 中华医学超声杂志(电子版), 2024, 21(06): 563-570.
[2] 葛睿, 陈飞, 李杰, 李娟娟, 陈涵. 多基因检测在早期乳腺癌辅助治疗中的应用价值[J]. 中华乳腺病杂志(电子版), 2024, 18(05): 257-263.
[3] 杨柳, 宋振川, 王新乐. 乳腺癌改良根治术联合背阔肌复位的临床疗效评估[J]. 中华乳腺病杂志(电子版), 2024, 18(05): 269-273.
[4] 王睿, 邓俊, 施廷鑫, 张志兆, 王成方, 张毅, 齐晓伟. FAM91A1 可能是乳腺癌患者的独立预后因子[J]. 中华乳腺病杂志(电子版), 2024, 18(05): 274-280.
[5] 季思涵, 唐新宇, 王邦杰, 狄汶洋, 王佳鸣, 查小明, 谢晖, 周文斌, 潘红, 王水. 阿贝西利在激素受体阳性、HER-2 阴性乳腺癌患者中的安全性研究[J]. 中华乳腺病杂志(电子版), 2024, 18(05): 281-286.
[6] 明昊, 肖迎聪, 巨艳, 宋宏萍. 乳腺癌风险预测模型的研究现状[J]. 中华乳腺病杂志(电子版), 2024, 18(05): 287-291.
[7] 王聪, 李云涛, 唐甜甜, 王鑫蕊, 吕鑫, 范志刚. 多基因检测对激素受体阳性、HER-2阴性乳腺癌新辅助化疗疗效预测的研究进展[J]. 中华乳腺病杂志(电子版), 2024, 18(05): 292-296.
[8] 胡文钰, 徐东东, 李南林. 早期乳腺癌全身辅助治疗的研究现状[J]. 中华乳腺病杂志(电子版), 2024, 18(05): 297-303.
[9] 于桐, 孙姗姗, 刘扬. 乳腺导管原位癌的浸润转化机制及临床病理特征[J]. 中华乳腺病杂志(电子版), 2024, 18(05): 304-307.
[10] 潘荔生, 刘忠强, 周莹莹, 陈勃, 李晏宁, 徐金锋, 蔡隆梅, 王宏梅. 乳腺癌内乳淋巴结的诊断和治疗[J]. 中华乳腺病杂志(电子版), 2024, 18(05): 308-314.
[11] 张志兆, 王睿, 郜苹苹, 王成方, 王成, 齐晓伟. DNMT3B与乳腺癌预后的关系及其生物学机制[J]. 中华普外科手术学杂志(电子版), 2024, 18(06): 624-629.
[12] 王玲艳, 高春晖, 冯雪园, 崔鑫淼, 刘欢, 赵文明, 张金库. 循环肿瘤细胞在乳腺癌新辅助及术后辅助治疗中的应用[J]. 中华普外科手术学杂志(电子版), 2024, 18(06): 630-633.
[13] 赵林娟, 吕婕, 王文胜, 马德茂, 侯涛. 超声引导下染色剂标记切缘的梭柱型和圆柱型保乳区段切除术的效果研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(06): 634-637.
[14] 陈伟杰, 何小东. 胆囊癌免疫靶向治疗进展[J]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 763-768.
[15] 张润锦, 阳盼, 林燕斯, 刘尊龙, 刘建平, 金小岩. EB病毒相关胆管癌伴多发转移一例及国内文献复习[J]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 865-869.
阅读次数
全文


摘要