| ObjectiveTo explore the clinical efficacy, CEA, immune function and others of dendritic cells immunotherapy combined with RFA therapy in colorectal cancer liver metastases.Methods1.We collected 46 cases who were diagnosed with colorectal cancer with liver metastasis between August 2012 to August 2014 in The 81st Hospital of PLA, and the patients were treated by random voluntary choice treatment.2. According to whether combined with DC immunotherapy,46 patients who treated with RFA were divided into two groups:the combined treatment group (26 cases who treated with DC and RFA therapy)and the control group(20 cases who treated with RFA).2.Using the blood cell separator for peripheral blood mononuclear cell, we can have sensitized DC vaccine after 8days,which were sended to the cell culture room.After having qualified cells,we can returned immunocompetent cells intravenously to patients.3.Analysis the change of immune function, recent effective,long term efficiency, quality of life,CEA level,safety of DC between two groups after treatment.5.In this retrospective research method, we use SPSS 18 statistical software for statistical, and the count data were compared with chi-square test while the measurement data with t-test. The two group were compared with the curative effect using rank-sum test. We calculate the patients'survival by using the Kaplan-Meier method,while the survival rates of two groups compared with the Log-Rank method.P value of<0.05 was considered statistically significant.Results1. Therapeutic efficacy1.1 Recent efficacy:the efficacy of the DC-RFA group (92.31%) was significantly better than the RFA group (70%).1.2 Prospective efficacy:16 of 26 cases died in the DC-RFA group,and 14 of 20 cases died in the RFA group. OS of the DC-RFA group was 4-37 month, mid-OS was 17 month? OS of RFA group was 4-28 month, mid-OS was 15 month? There was no significant difference is noticed between the two groups.2. Evaluation of immune functionThe radios of CD3+?CD4+ and CD4+/CD8+ of the RFA group were increased after treatment, all the differences showed statically significant. The proportion of CD3+? CD4+ and CD4+/CD8+ of the DC-RFA group were increased after treatment, all the differences showed statically significant. Compared with two groups, the radios of CD3+?CD4+ and CD4+/CD8+ of the DC-RFA group were higher than the RFA group after treatment, and the differences showed statistically significant.3. Evaluation of quality of lifeIn the DC-RFA group, there were got higher quality of life than the RFA group, and the improvement in quality of life had significant difference between two groups,especially in mental state and pain control.4. Evaluation of CEA levelIn the DC-RFA group, there were 16 patients (61.54%) with positive CEA level, and 10 patients (50%) with positive CEA level in the RFA group, but no statistically significant difference is noticed between the two groups.5. Evaluation of safety of DC therapyAfter receiving cell immunotherapy of 46 patients, there was no fever,allergic and others adverse reactions. In long term follow-up after DC treatment, we didn't find liver, renal function immune function in all patients.Conclusion1. Compared to RFA alone,The DC immunotherapy combine with RFA can help to improve the recent efficient, but there was no significant difference in overall survival.2. The DC immunotherapy can help to reduce the patient's CEA level; and compared to RFA alone, instead of aggravate the injury in patient's immune function, combination therapy may help to make some improvement.3. DC immunotherapy with RFA can improve the quality of life in patients with Colorectal cancer liver metastasis, especially in the pain control and mental status.4. DC immunization therapy has no significant side effects, and is repeatable, safe reliable. |
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