| Object:To compare the efficacy of postoperative adjuvant chemotherapy combined with DC-CTL treatment and postoperative adjuvant chemotherapy treatment alone in colorectal adenocarcinoma patients who belong to phase Ⅱ of high risk and phase Ⅲ after radical operations.Methods:1.We collected the patients of high-risk stage Ⅱ and stage Ⅲ colon cancer and high rectal cancer patients who were hospitalized during the period 2013-11 to 2015-12.All the patients had undergone radical surgery and diagnosed with adenocarcinoma.A total of 58 patients were collected,and 21 patients were in the combined treatment group,who were accepted the treatments of chemotherapy and DC-CTL,while 37 patients were in the control group who were not accepted the DC-CTL treatments.C linical characteristics and other dates were collected and retrospectively analyzed,and there was no significant difference in the baseline information about sex,disease stage,histological differentiation and previous treatments.Followed-up ended in January 2017.2.Survival analysis was used to compare the time of mDFS(median disease-free survival),1 year and 2 years of DCR(disease control rate)of the two groups.COX regression analysis was used to find the prognostic risk factors.Campare the serum C EA before and after chemotherapy or DC-CTL treatments.The adverse reactions,ECOG score and quality of life were analyzed in the two groups.Results1.Based on the K-M curve analysis,the mDFS(the median disease-free survival)of patients was significantly prolonged in the combined group(combined group 36.4 months vs.chemotherapy group 27.3 months,P =0.047).When postoperative staging,whether has lymph node infiltration,degree of differentiation,disease location and treatment methods were entered into the COX multivariate regression model analysis,results revealed the following: postoperative adjuvant therapy is not a significant prognostic factors: the risk of recurrence for chemotherapy alone is 2.190 times(95% CI: 0.676-7.096,P =0.191)of the treatment combined with DC-CTL.While,the disease staging and differentiation both were the significant prognositic factors.1 year of DC R in the combined treatment group and control group were 82.6 % vs.94.4%(P =0.213),while the 2 year of DCR were 61.6% vs.73.4% respectively(P =0.273).There was no significant change in serum C EA before and after the treatments in the combined treatment group,which was 4.15(3.175-8.240)ng/ml,4.71(3.9-10.74)ng/ml(P =0.792).2.The main adverse reactions caused by chemotherapy were myelosuppression,nausea,vomiting,hair loss and other adverse reactions,mostly between I-Ⅲ levels.During the DC-CTL treatment process,1/21 patients had a transient fever to 38.0 ℃,and the temperature returned to normal after given the physical cooling.No patients were observed with rash,allergies,shock and other serious adverse reactions and treatment-related deaths.ECOG score in combined group were decreased obviously after given the DC-CTL treatments(P=0.015).The general situation of patients with schistosomiasis,diet,sleep,etc were collected and analyzed as the quality of life after DC-CTL treatment: 13/21 patients said that the general situation was improved compared to the situation before DC-CTL treatment,and 8/21 patients showed no significant changes in the general situation.Conclusions:Compared with postoperative chemotherapy alone,postoperative adjuvant chemotherapy combined with autoimmune cell therapy ca n extend the DFS of patients,but difference of 1 year ‘s and 2 years ‘s disease control rate of patients in the two groups was not significance.DC-CTL treatment for patients can bring less adverse reactions,and improved the quality of life. |
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