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目的探讨链式细胞因子诱导的杀伤细胞(CIK)联合放疗和微波热疗治疗局部晚期直肠癌的临床疗效。方法选取2013年1月到2014年1月青岛市胶州中心医院已确诊的64例局部晚期直肠癌患者,按照随机数字表法随机分为观察组和对照组,观察组(32例)采用链式CIK联合放疗和微波热疗治疗,对照组(32例)采用单纯放疗联合微波热疗治疗。观察比较两组患者治疗3个疗程、6个疗程和9个疗程时T细胞亚群CD3~+、CD4~+、CD8~+、CD4~+/CD8~+的变化、治疗结束后第1~6个月、1年和2年时患者的随访情况。结果观察组患者治疗效果完全缓解、部分缓解、稳定、进展比率分别为46.9%、31.4%、12.5%和6.30%;对照组为28.1%、25.0%、31.1%和15.6%。观察组患者总缓解率为78.3%,对照组为53.1%,观察组明显高于对照组(P<0.05)。观察组和对照组CD3~+和CD4~+均逐渐增大,CD8~+均减少,但与治疗前比较,观察组患者变化率明显高于对照组。9个疗程后,观察组CD4~+/CD8~+比值为(1.59±0.40),对照组为(1.44±0.46),差异有统计学意义(P<0.05)。观察组疾病控制率在1~6个月、1年、2年这3个时间段分别为96.9%、90.6%和87.5%,对照组为84.4%、78.1%和56.3%,观察组明显高于对照组,差异有统计学意义(P<0.05)。结论链式CIK联合放疗和微波热疗治疗局部晚期直肠癌可以提高患者治疗效果和免疫能力,增长患者的存活期。
Objective To investigate the clinical efficacy of chain cytokine-induced killer (CIK) combined with radiotherapy and microwave hyperthermia in the treatment of locally advanced rectal cancer. Methods From January 2013 to January 2014, 64 patients with locally advanced rectal cancer diagnosed in Jiaozhou Central Hospital of Qingdao were randomly divided into observation group and control group according to the random number table method. The observation group (32 cases) CIK combined with radiotherapy and microwave hyperthermia treatment, control group (32 cases) with radiotherapy combined with microwave hyperthermia. The changes of CD3 +, CD4 +, CD8 +, CD4 + / CD8 + of T cell subsets in 3 courses, 6 courses and 9 courses of treatment were observed and compared between the two groups. After the treatment, 6 months, 1 year and 2 years of follow-up of patients. Results The therapeutic effect of the observation group was completely relieved. The rates of partial remission, stabilization and progression were 46.9%, 31.4%, 12.5% and 6.30% respectively in the observation group and 28.1%, 25.0%, 31.1% and 15.6% in the control group. The total remission rate was 78.3% in the observation group and 53.1% in the control group, which was significantly higher in the observation group than in the control group (P <0.05). The levels of CD3 ~ + and CD4 ~ + in the observation group and the control group increased gradually and the CD8 ~ + decreased, but the change rate in the observation group was significantly higher than that in the control group. After 9 courses of treatment, the ratio of CD4 ~ + / CD8 ~ + in the observation group was (1.59 ± 0.40) and in the control group (1.44 ± 0.46), the difference was statistically significant (P <0.05). In the observation group, the disease control rates were 96.9%, 90.6% and 87.5% in 1 to 6 months, 1 year and 2 years, respectively, and 84.4%, 78.1% and 56.3% in the control group. The observation group was significantly higher than the control group Control group, the difference was statistically significant (P <0.05). Conclusions Chain-CIK combined with microwave and hyperthermia in the treatment of locally advanced rectal cancer can improve the therapeutic effect and immunocompetence and increase the survival of patients.