{"title":"术后化疗和细胞免疫疗法对结直肠癌患者的影响。","authors":"Zhen-Yu Ding, Ying Piao, Tong Jiang, Juan Chen, Yi-Nuo Wang, Hui-Ying Yu, Zhen-Dong Zheng","doi":"10.4240/wjgs.v16.i10.3202","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The outcome of surgical treatment for colorectal cancer (CRC) remains unsatisfactory and warrants further exploration and optimization.</p><p><strong>Aim: </strong>To clarify the impact of chemotherapy plus cellular immunotherapy [dendritic cell-cytokine-induced killer (DC-CIK) cell immunotherapy] on patients after CRC surgery and to explore the mediating variables.</p><p><strong>Methods: </strong>A total cohort of 121 patients who underwent CRC surgery between January 2019 and April 2022 were selected. The sample comprised a control group of 55 patients who received the XELOX chemotherapy regimen and a research group of 66 patients who received XELOX + DC-CIK immunotherapy. We performed comparative analyses of the clinical and pathological data of the two groups, including efficacy (2-year disease-free survival [DFS] rate), the incidence of adverse events (diarrhea, myelosuppression, gastrointestinal reactions, and peripheral neuritis), serum levels of tumor markers [carcinoembryonic antigens and carbohydrate antigens (CA)19-9 and CA242], and T-cell subsets [cluster of differentiation (CD)3<sup>+</sup>, CD3<sup>+</sup> CD4<sup>+</sup>, CD3<sup>+</sup> CD8<sup>+</sup>, natural killer (NK), and NK T cells]. We also conducted preliminary univariate and multivariate analyses of the variables that affected the efficacy of the treatments.</p><p><strong>Results: </strong>We found a significantly higher 2-year DFS rate of treatment efficacy in the research group than in the control group, with a statistically lower incidence of adverse events. Both groups showed a reduction in serum tumor markers after treatment but there was no marked intergroup difference. After treatment, the various T-cell subgroup indicators in the control group were significantly lower than those in the research group. The indices of T-cell subsets in the research group showed no significant change from preoperative levels. Univariate analysis revealed a significant correlation between TNM staging, tumor differentiation, and the rates of nonresponse to treatment in CRC patients after surgery. Multivariate results indicated that the treatment approach significantly affected the efficacy of postoperative CRC treatment.</p><p><strong>Conclusion: </strong>We concluded that XELOX + DC-CIK immunotherapy for postsurgical CRC patients offers reduced rates of treatment-induced adverse events, extended 2-year DFS, enhanced immunity, and increased physiological antitumor responses.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"16 10","pages":"3202-3210"},"PeriodicalIF":1.8000,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577400/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effects of postoperative treatment with chemotherapy and cellular immunotherapy on patients with colorectal cancer.\",\"authors\":\"Zhen-Yu Ding, Ying Piao, Tong Jiang, Juan Chen, Yi-Nuo Wang, Hui-Ying Yu, Zhen-Dong Zheng\",\"doi\":\"10.4240/wjgs.v16.i10.3202\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The outcome of surgical treatment for colorectal cancer (CRC) remains unsatisfactory and warrants further exploration and optimization.</p><p><strong>Aim: </strong>To clarify the impact of chemotherapy plus cellular immunotherapy [dendritic cell-cytokine-induced killer (DC-CIK) cell immunotherapy] on patients after CRC surgery and to explore the mediating variables.</p><p><strong>Methods: </strong>A total cohort of 121 patients who underwent CRC surgery between January 2019 and April 2022 were selected. The sample comprised a control group of 55 patients who received the XELOX chemotherapy regimen and a research group of 66 patients who received XELOX + DC-CIK immunotherapy. We performed comparative analyses of the clinical and pathological data of the two groups, including efficacy (2-year disease-free survival [DFS] rate), the incidence of adverse events (diarrhea, myelosuppression, gastrointestinal reactions, and peripheral neuritis), serum levels of tumor markers [carcinoembryonic antigens and carbohydrate antigens (CA)19-9 and CA242], and T-cell subsets [cluster of differentiation (CD)3<sup>+</sup>, CD3<sup>+</sup> CD4<sup>+</sup>, CD3<sup>+</sup> CD8<sup>+</sup>, natural killer (NK), and NK T cells]. We also conducted preliminary univariate and multivariate analyses of the variables that affected the efficacy of the treatments.</p><p><strong>Results: </strong>We found a significantly higher 2-year DFS rate of treatment efficacy in the research group than in the control group, with a statistically lower incidence of adverse events. Both groups showed a reduction in serum tumor markers after treatment but there was no marked intergroup difference. After treatment, the various T-cell subgroup indicators in the control group were significantly lower than those in the research group. The indices of T-cell subsets in the research group showed no significant change from preoperative levels. Univariate analysis revealed a significant correlation between TNM staging, tumor differentiation, and the rates of nonresponse to treatment in CRC patients after surgery. 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引用次数: 0
摘要
背景:目的:明确化疗加细胞免疫疗法[树突状细胞-细胞因子诱导的杀伤细胞(DC-CIK)免疫疗法]对CRC术后患者的影响,并探讨其中介变量:选取2019年1月至2022年4月期间接受CRC手术的121名患者作为研究对象。样本包括接受 XELOX 化疗方案的 55 例对照组和接受 XELOX + DC-CIK 免疫疗法的 66 例研究组。我们对两组患者的临床和病理数据进行了对比分析,包括疗效(2 年无病生存率[DFS])、不良反应(腹泻、骨髓抑制、胃肠道反应和外周神经炎)的发生率、癌胚抗原、碳水化合物抗原 (CA)19-9 和 CA242],以及 T 细胞亚群[分化簇 (CD)3+、CD3+ CD4+、CD3+ CD8+、自然杀伤 (NK) 和 NK T 细胞]。我们还对影响疗效的变量进行了初步的单变量和多变量分析:结果:我们发现研究组的 2 年 DFS 疗效明显高于对照组,不良反应发生率也低于对照组。两组治疗后血清肿瘤标志物均有所下降,但组间差异不明显。治疗后,对照组的各种 T 细胞亚群指标明显低于研究组。研究组的 T 细胞亚群指标与术前水平相比无明显变化。单变量分析显示,TNM 分期、肿瘤分化与 CRC 患者术后对治疗无反应率之间存在明显相关性。多变量结果显示,治疗方法对术后 CRC 的疗效有显著影响:我们得出结论:XELOX + DC-CIK 免疫疗法为术后 CRC 患者降低了治疗引起的不良反应率,延长了 2 年的 DFS,增强了免疫力,提高了生理性抗肿瘤反应。
Effects of postoperative treatment with chemotherapy and cellular immunotherapy on patients with colorectal cancer.
Background: The outcome of surgical treatment for colorectal cancer (CRC) remains unsatisfactory and warrants further exploration and optimization.
Aim: To clarify the impact of chemotherapy plus cellular immunotherapy [dendritic cell-cytokine-induced killer (DC-CIK) cell immunotherapy] on patients after CRC surgery and to explore the mediating variables.
Methods: A total cohort of 121 patients who underwent CRC surgery between January 2019 and April 2022 were selected. The sample comprised a control group of 55 patients who received the XELOX chemotherapy regimen and a research group of 66 patients who received XELOX + DC-CIK immunotherapy. We performed comparative analyses of the clinical and pathological data of the two groups, including efficacy (2-year disease-free survival [DFS] rate), the incidence of adverse events (diarrhea, myelosuppression, gastrointestinal reactions, and peripheral neuritis), serum levels of tumor markers [carcinoembryonic antigens and carbohydrate antigens (CA)19-9 and CA242], and T-cell subsets [cluster of differentiation (CD)3+, CD3+ CD4+, CD3+ CD8+, natural killer (NK), and NK T cells]. We also conducted preliminary univariate and multivariate analyses of the variables that affected the efficacy of the treatments.
Results: We found a significantly higher 2-year DFS rate of treatment efficacy in the research group than in the control group, with a statistically lower incidence of adverse events. Both groups showed a reduction in serum tumor markers after treatment but there was no marked intergroup difference. After treatment, the various T-cell subgroup indicators in the control group were significantly lower than those in the research group. The indices of T-cell subsets in the research group showed no significant change from preoperative levels. Univariate analysis revealed a significant correlation between TNM staging, tumor differentiation, and the rates of nonresponse to treatment in CRC patients after surgery. Multivariate results indicated that the treatment approach significantly affected the efficacy of postoperative CRC treatment.
Conclusion: We concluded that XELOX + DC-CIK immunotherapy for postsurgical CRC patients offers reduced rates of treatment-induced adverse events, extended 2-year DFS, enhanced immunity, and increased physiological antitumor responses.