| 生物免疫治疗非小细胞肺癌的系统评价和Meta分析 |
| Alternative Title | Biological immune therapy for non-small cell lung cancer: A Systematic Review and Meta-Analysis
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| 任维维 |
| Thesis Advisor | 米登海
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| 2014-05-24
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| Degree Grantor | 兰州大学
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| Place of Conferral | 兰州
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| Degree Name | 硕士
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| Keyword | 非小细胞肺癌
生物免疫疗法
过继免疫
细胞因子
基因治疗
重组人p53 腺病毒
Meta分析
系统评价
随机对照试验
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| Abstract | 目的：系统评价生物免疫治疗非小细胞肺癌的疗效与安全性。
方法：首先通过计算机检索电子数据库，再结合其他检索途径，收集所有关于生物免疫治疗非小细胞肺癌的随机对照试验（randomized controlled trial，RCT）。
结果： （1）过继免疫细胞疗法：近期总有效率优于对照组 (P＝0.004)；经过亚组分析，DC-CIK细胞疗法近期总有效率优于对照组(P＝0.006)；有利于提高患者的1，2，3年生存率(P＝0.006)，(P＝0.0005)，(P＝0.01)；有利于降低患者死亡的风险(P＜0.00001)；能明显改善患者的免疫功能（CD3+，CD4+，NK细胞计数升高，CD8+细胞计数降低）（P＜0.05）；并且联合化疗能明显改善患者白细胞降低的水平 (P=0.0001)。
（2）细胞因子疗法：细胞因子IL-2疗法近期总有效率优于对照组 (P＝0.0008)；但未能提高患者的1，2年生存率 (P＝0.15)，(P＝0.36)。
（3）基因治疗：重组人p53腺病毒疗法治疗非小细胞肺癌的近期总有效率优于对照组 (P＝0.03)；治疗相关胸腔积液的近期总有效率优于对照组 (P＜0.0001)；并未能改善患者的1年生存率 (P＝0.72)；在治疗相关胸腔积液时，不增加发热的发生率（P＝0.11）。
结论：生物免疫疗法与手术、化疗、放疗等疗法有机结合治疗非小细胞肺癌，能提高治疗效果，但作为一种新的治疗手段，目前尚缺乏大样本的、长时间随访的严格的临床研究资料。 |
| Other Abstract | Objective: To evaluate the clinical efficacy and safety of biological immune therapy for non-small cell lung cancer.
Methods: Relevant randomized controlled trials (RCTs) were searched in electronic databases. Meanwhile we searched the dates through other means.
Results: (1) The overall analysis revealed significantly that adoptive cellular immunotherapy improve the overall response rate (P=0.004), as well as DC-CIK cell (P=0.006).Moreover adoptive cellular immunotherapy could increase 1-, 2-, 3-year overall survival rate (P=0.006; P=0.0005; P=0.01), reduced risk of death for overall survival (P<0.00001), and increase immune function (P<0.05). However, no statistically significant difference was observed for adverse events between groups with adoptive immunotherapy and without adjuvant treatment (P>0.05).
(2) The overall analysis revealed significantly that interleukin 2 therapy improve the overall response rate (P=0.0008). Unfortunately, interleukin 2 therapy could not increase 1-, 2-year overall survival rate (P=0.15; P=0.36). However, no statistically significant difference was observed for adverse events between groups with interleukin 2 of cytokine and without adjuvant treatment (P>0.05).
(3) The overall analysis revealed significantly that recombinant adenovirus-p53 therapy improve the overall response rate in treating NSCLC (P=0.03) and malignant pleural effusion (P<0.0001). Unfortunately, recombinant adenovirus-p53 therapy could not increase 1-year overall survival rate (P=0.72). There was no statistically significant difference of adverse events (P>0.05).
Conclusion: biological immune therapy with surgery, chemotherapy and radiotherapy could improve the therapeutic effect for non-small cell lung cancer. But as a new treatment at present, there were lack of the large sample and rigorous clinical research data of long follow-up. |
| URL | 查看原文
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| Language | 中文
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| Document Type | 学位论文
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| Identifier | https://ir.lzu.edu.cn/handle/262010/222719
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| Collection | 学院待认领
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| Affiliation | 临床医学院
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Recommended Citation
GB/T 7714 |
任维维. 生物免疫治疗非小细胞肺癌的系统评价和Meta分析[D]. 兰州. 兰州大学,2014.
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