Clinical Efficacy And Safety Of The DC-CIK Cellular Immune Therapy In Advanced Pancreatic Cancer

Objective To investigate the treatment of patients with advanced pancreatic cancer after chemotherapy DC-CIK cells were applied to observe the clinical efficacy and safety, it may be advantageous to provide a reference for selecting the treatment of advanced pancreatic cancer.Methods In our hospital treated 78 patients with advanced pancreatic cancer patients as this study. According to the different treatment patients were divided into a control group and the observation group, the 39 patients in the control group in which patients after palliative surgery, chemotherapy alone; and observe patients after palliative surgery, chemotherapy, based on the joint itself DC-CIK cell immunotherapy. Were detected in the peripheral blood of patients before and after treatment changes in T cell subsets and regulatory T cells and inflammatory cytokines IFN-γ and IL-4 levels were observed toxicity during treatment and after treatment groups were always there efficiency and clinical benefit rate, and two-year follow-up, survival and mortality observed in patients.Results(1) Before and after treatment, the CD3+ percentage were respectively(57.18±6.64)% and(67.39±10.83)% in observed group, significantly different statistically significant(P <0.05). Before and after treatment, the CD4+ percentage were respectively(23.56±4.33)% and(32.94±5.68)% in observed group, significantly different statistically significant(P <0.05). Before and after treatment, the CD8+ percentage were respectively(30.53±4.27)% and(26.55±3.64)% in observed group, significantly different statistically significant(P <0.05). Before and after treatment, the CD4+/CD8+ were respectively 0.77±0.17 and 1.24±0.35 in observed group, significantly different statistically significant(P <0.05). Before and after treatment, the CD3+CD56+ percentage were respectively(6.44 ± 1.73)% and(13.58 ± 2.69)% in observed group, significantly different statistically significant(P <0.05). Before and after treatment, the CD4+CD25+CD127low percentage were respectively(10.83 ± 2.65)% and(7.31 ± 2.82)% in observed group, significantly different statistically significant(P <0.05). Before and after treatment, the CD3+ percentage were respectively(55.79 ± 6.42)% and(48.83 ± 5.91)% in control group, significantly different statistically significant(P <0.05). Before and after treatment, the CD4+ percentage were respectively(24.07 ± 4.39)% and(21.05 ± 4.13)% in control group, significantly different statistically significant(P <0.05). Before and after treatment, the CD8+ percentage were respectively(31.12 ± 4.08)% and(28.82 ± 4.19)% in control group, significantly different statistically significant(P <0.05). Before and after treatment, the CD4+/CD8+ were respectively 0.77±0.22 and 0.74±0.19 in control group, the difference is not obvious, was not statistically significant(P> 0.05). Before and after treatment, the CD3+CD56+ percentage were respectively(6.19 ± 1.61)% and(4.58 ± 1.74)% in control group, significantly different statistically significant(P <0.05). Before and after treatment, the CD4+CD25+CD127low percentage were respectively(10.69 ± 2.72)% and(8.54 ± 2.68)% in control group, significantly different statistically significant(P <0.05). Before treatment, the indicators of the two groups was not statistically significant(P> 0.05); after treatment, compared with the control group, the observation group, the percentage of CD8+, CD4+CD25+CD127low Treg fall more significantly, with statistical significance(P <0.05).(2) Before and after treatment, IFN-γ levels in the observation group were 11.31±2.14pg/ml, 13.62±2.45 p ml, significantly different statistically significant(P <0.05); IL-4 levels were 8.9 ± 2.04pg/ml, 6.87±1.66pg/ml, significantly different statistically significant(P<0.05). Before and after treatment, the level of IFN-γ in the control group were 11.88±2.30pg/ml, 8.93±2.07pg/ml, significantly different statistically significant(P<0.05); IL-4 levels were 8.99±2.17pg/ml, 7.22±1.71pg/ml, significantly different statistically significant(P<0.05). Before treatment, the two groups of IFN-γ and IL-4, the difference was not significant, was not statistically significant(P> 0.05); after treatment, the two groups were compared to IFN-γ, the difference was statistically significant(P <0.05), while IL-4 was no statistically significant difference(P> 0.05).(3) There are 2 cases(5.13%) of complete remission(CR), 7 cases(17.95%) of partial remission, 18 cases(46.15%) of stable(SD), 12 cases(30.77%) of progression(PD), 9 cases(23.08%) of total effective, 27 cases(69.23%) of clinical benefit in observe group. There are 0 case(0%) of complete remission(CR), 4 cases(10.26%) of partial remission, 12 cases(30.77%) of stable(SD), 23 cases(58.97%) of progression(PD), 4 cases(10.26%) of total effective, 27 cases(69.23%) of clinical benefit in control group. The total efficiency of the two groups were compared, and clinical benefit rate, significantly different statistically significant(P <0.05).(4) 28 cases of death in patients in the observation group, the median survival of 12.5 months, the average progression-free survival of 11.7 months, 1 year survival rate was 53.85%; control group, 39 cases of death in patients, the median survival of 6.4 months, the average progression-free survival 8.1 months, 1-year survival rate was 25.64%. Two groups of patients died compared survival and 1-year survival rate, the difference was significant, with statistical significance(P <0.05).(5) There are 10 cases(25.64%) of lower hemoglobin, 7 cases(17.95%) of leukopenia, 9 cases(23.08%) of gastrointestinal reactions, 6 cases(15.38%) of peripheral neurotoxicity, 10 cases(25.64%) of rash, 13 cases(33.33%) of abnormal liver function in observe group. There are 17 cases(43.59%) of lower hemoglobin, 9 cases(23.08%) of leukopenia, 22 cases(56.41%) of gastrointestinal reactions, 18 cases(46.15%) of peripheral neurotoxicity, 8 cases(20.51%) of rash, 16 patients(41.03%) of abnormal liver function in control group. The difference of patients decreased hemoglobin, gastrointestinal reactions and peripheral neurotoxicity were significant, with statistical significance(P<0.05); the two groups were, the difference of leukopenia, rash and abnormal liver function were not statistically significant(P> 0.05).Conclusions(1) Chemotherapy and immunotherapy DC-CIK cells can reduce the number of patients with advanced pancreatic regulatory T cells to maintain Thl /Th2 balance, improve immune function of T lymphocytes.(2) Chemotherapy combined DC-CIK cell-mediated immunity in patients with advanced pancreatic total efficiency, clinical benefit rate, survival rate, longer survival, with better efficacy and long-term efficacy.(3) Chemotherapy combined DC-CIK cell-mediated immunity in patients with advanced pancreatic cancer, the incidence of side effects, safe, have clinical significance.