| Background:In recent years, the increasing incidence of breast cancer, seriously endanger the health of women. Some of the cities in our country, the incidence of breast cancer has been situated at1st place in female malignant tumors. Every year, there are more or less169thousand people who have been taken breast cancer. Even given regular treatment, about one-third of the patients in the afteroperation have relapsed and metastasized within5years.Advanced metastatic breast cancer cannot be cured. The treatment goal is to control the disease symptoms, improve the quality of survival, relieve pain, and prolong the survival time as far as possible. Now it is the main systemic therapy on the treatment of the comprehensive treatment. Chemotherapy still plays an important role. The curative effect of combination chemotherapy is generally better than single-agent chemotherapy. The effective rate of the first-line chemotherapy of advanced metastatic breast cancer is45%-80%, the median remission is5-13months, and the life span of effective cases is usually15-33months. However, chemotherapy drug has the problem of drug resistance. The toxic and side-effect of chemotherapy influenced the patients’health and life quality a lot, especially the patients of advanced stage.What’s more, routine chemotherapy caused the immune function of patients further underground, and so they have more risk of concurrent infection, etc. These reasons have significantly limited the application of chemotherapy to a certain extent. Surgery and radiation therapy in the comprehensive treatment of recurrence and metastatic breast cancer just as some partial pressure to relieve some symptoms of palliative therapy. Biological therapy has shown its broad clinical application prospect as the fourth model after surgery, chemotherapy and radiation therapy in the treatment of malignant tumor.Targeted therapy is a hotspot of research on the advanced breast cancer treatment, and shows good curative effect in selective patients. Trastuzumab has been approved for the treatment of metastatic breast cancer with Her-2overexpression; as the single drug therapy the metastatic breast cancer patients who has received one or more chemotherapy; combine paclitaxel to therapy the metastatic breast cancer patients who has never received chemotherapy. However, it is confirmed that Her-2/neu is expressed in only25%of all breast cancer patients, and this treatment is very expensive. Because of the shortage of the conventional treatment, exploring new methods of comprehensive treatment to improve the survival and life quality of advanced metastatic breast cancer patients has an important significance. Cytokine-Induced Killer is a group of heterogeneous T lymphocytes which main force is the CD3+CD56+T cells. It has the MHC non-restricted power tumor-killer advantages of T lymphocytes and NK cell, and become the preferred clinical solution of adoptive immunotherapy.For the past few years, there are more and more related clinical trials about the application of CIK cells adoptive immunity therapy for solid tumor.There are many clinical study report about CIK cells combined chemotherapy In the treatment of metastatic breast cancer. They results also show that the therapeutic alliance has a better curative effect. So far phase I and phase Ⅱ clinical trials have show that CIK cells can effectively inhibit and kill breast cancer cells, and no obvious adverse reactions. However, there are few researches at home or abroad in phase III clinical trials of CIK cell in the treatment of advanced metastatic breast cancer. In this paper, we compared the clinical curative effect and side-effects between chemotherapy plus CIK biotherapy and chemotherapy alone using a retrospective clinical study way, hoping to find a new strategy to cure the advanced metastatic breast cancer.Materials and methods:41cases of patients with diagnosed breast cancer from the Affiliated Tumor Hospital of Zhengzhou University from01/2010to13/09/2012were analyzed. All the patients were divided to two groups, group A:chemotherapy combine CIK cells transfusion, group B:chemotherapy alone.Evaluate the recent curative effect useing the evaluation criterion in RECIST1.1. Evaluate the adverse reaction during the course of treatment in accordance with the anti-cancer drug adverse reaction NCI-CTC version3.0We compared the baseline characteristics, objective response rates (ORR), disease control rate (DCR), progression-free survival (PFS), related adverse reactions of the two groups and the safty of CIK cells transfusion.SPSS17.0was used to analyze data. The survival curves were analyzed by the Kaplan-Meier method and log-rank test. The ORR, DCR rate comparison were analyzed by Chi-square test, P<0.05was considered statistically significant. COX proportional hazards models used to analyze the prognostic factors.Results:1、 The baseline characteristics of the two groups were compared through a chi-square test. There was not significant statistical difference between the two groups.2、 The median PFS was13.00months (95%CI11.12-14.88months) in group A and8.00months (95%CI5.40-10.60months) in group B, There was significant statistical difference between the two groups, P=0.047<0.05.3、 The ORR was42.10%and40.90%in groups A and B, respectively. There was no significant statistical difference between the two groups, χ2=0.006, P=0.938.4、 The DCR was84.21%and81.82%in groups A and B, respectively. There was no significant statistical difference between the two groups,χ2=0.041, P<0.839.5、 The incidence of White blood cells reduction (χ2=1.22, P=0.88) and Nausea and vomiting (χ2=2.24, P=0.52) in group A was lower than in group B, There was no significant statistical difference between the two groups; The incidence of anorexia (x2=10.74, P=0.004) and feeble (x2=22.11, P=0.00) in group A was lower than in group B, There was significant statistical difference between the two groups.6%The incidence of fever in group A was21.05%. The highest temperature is38.8degrees Celsius, and all did not affect the treatment.7^COX proportional hazards regression model shows that the number of metastases in patients are independent factors affecting the prognosis of patients (P=0.018, OR=2.040).Conclusions:Treatment with chemotherapy combined with CIK cells is superior to using chemotherapy alone in patients with advanced metastatic breast cancer, and can prolong the progression-free survival of patients. This treatment method is safe, well tolerated, and can obviously reduce the incidence of patients with anorexia and feeble,more suitable to poor patients. |
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