兰州大学机构库 >学院待认领
生物免疫治疗非小细胞肺癌的系统评价和Meta分析
Alternative TitleBiological immune therapy for non-small cell lung cancer: A Systematic Review and Meta-Analysis
任维维
Thesis Advisor米登海
2014-05-24
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
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
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 AbstractObjective: 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
Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/222719
Collection学院待认领
Affiliation临床医学院
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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