Abstract:
Objective:To evaluate the efficacy of cytokineinduced killer cells(CIK)in treatment of patients with renal cell carcinoma. Methods: All the patients were diagnosed as renal cell carcinoma in Affiliated Cancer Hospital of Tianjin Medical University from January 2000 to July 2010. One hundred and nineteen patients received CIK treatment (CIK group) and 119 patients received treatment of IL2 in combination with IFN (control group). Of the 119 paired patients, 21 pairs had stage Ⅰ disease, 21 pairs stage Ⅱ, 49 stage Ⅲ, and 28 stage Ⅳ. Pairing consideration include clinical stage,sex,age,neutrophil count, platelet count,hemoglobin level,lactate dehydrogenase activity,β2microglobulin level and Karnofsky performance status at the time of diagnosis. Progressionfree survival (PFS) and overall survival (OS) were evaluated. Results:The 5year PFS and OS rates in the CIK and control groups were 44% and 42% (P=0.056), and 72% and 51% (P<0.001), respectively. The median PFS and OS in the CIK and control groups were 54 and 43 months (P=0.088), and 134 and 60 months (P<0.001), respectively. Patients with stage Ⅰ+Ⅱ disease in these two groups showed no statistical difference in PFS and OS. However, the 5year PFS and OS of stage Ⅲ+Ⅳ patients in the CIK group were significantly higher than those in the control group (26% vs 18%, P<0.001, and 58% vs 31%, P<0.001; respectively), the median PFS and OS of stage Ⅲ+Ⅳ patients in the CIK group were also remarkably longer than those in the control group (36 months vs 13 months, P=0.005; and 68 months vs 33 months, P<0.001; respectively). In the multivariate analysis, the frequency of CIK immunotherapy was related to the PFS (HR=0.95, 95% CI: 0.92-0.99, P=0.013) and OS (HR=0.79, 95% CI: 0.71-0.87, P<0.001). The optimal outpoint of the frequency was seven times. Conclusion: CIK immunotherapy can improve the prognosis of stage Ⅲ and Ⅳ renal cell carcinoma patients and increasing the frequency of CIK treatment benefits patients more.