Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Oct 27, 2024; 16(10): 3202-3210
Published online Oct 27, 2024. doi: 10.4240/wjgs.v16.i10.3202
Effects of postoperative treatment with chemotherapy and cellular immunotherapy on patients with colorectal cancer
Zhen-Yu Ding, Ying Piao, Tong Jiang, Juan Chen, Yi-Nuo Wang, Hui-Ying Yu, Zhen-Dong Zheng
Zhen-Yu Ding, Ying Piao, Juan Chen, Zhen-Dong Zheng, Department of Oncology, General Hospital of Northern Theater Command, Shenyang 110016, Liaoning Province, China
Tong Jiang, Laboratory of Military Health in Cold Region, Center for Disease Control and Prevention of Northern Theater Command, Shenyang 110034, Liaoning Province, China
Yi-Nuo Wang, Department of Clinical Medicine, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning Province, China
Hui-Ying Yu, Basic Medicine Laboratory, General Hospital of Northern Theater Command, Shenyang 110016, Liaoning Province, China
Co-first authors: Zhen-Yu Ding and Ying Piao.
Author contributions: Ding ZY and Piao Y were the guarantors of the integrity of the entire study and wrote the manuscript as co-first authors; Ding ZY, Piao Y and Zheng ZD conceived the study and design; Ding ZY, Piao Y and Jiang T performed the literature review; Ding ZY, Wang YN and Yu HY conducted the study; Ding ZY, Piao Y and Jiang T conducted the statistical analyses; all authors have access to the data and contributed to the writing of this manuscript.
Supported by Natural Science Foundation of Liaoning Province, No. 2020JH2/10300160.
Institutional review board statement: This study was approved by the Ethic Committee of General Hospital of Northern Theater Command.
Informed consent statement: Informed consent to participate in this study was obtained from each patient.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhen-Dong Zheng, PhD, Chief Physician, Department of Oncology, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenyang 110016, Liaoning Province, China. zzd_oncologist@163.com
Received: August 1, 2024
Revised: August 30, 2024
Accepted: September 3, 2024
Published online: October 27, 2024
Processing time: 57 Days and 19.7 Hours
Abstract
BACKGROUND

The outcome of surgical treatment for colorectal cancer (CRC) remains unsatisfactory and warrants further exploration and optimization.

AIM

To clarify the impact of chemotherapy plus cellular immunotherapy [dendritic cell-cytokine-induced killer (DC-CIK) cell immunotherapy] on patients after CRC surgery and to explore the mediating variables.

METHODS

A total cohort of 121 patients who underwent CRC surgery between January 2019 and April 2022 were selected. The sample comprised a control group of 55 patients who received the XELOX chemotherapy regimen and a research group of 66 patients who received XELOX + DC-CIK immunotherapy. We performed comparative analyses of the clinical and pathological data of the two groups, including efficacy (2-year disease-free survival [DFS] rate), the incidence of adverse events (diarrhea, myelosuppression, gastrointestinal reactions, and peripheral neuritis), serum levels of tumor markers [carcinoembryonic antigens and carbohydrate antigens (CA)19-9 and CA242], and T-cell subsets [cluster of differentiation (CD)3+, CD3+ CD4+, CD3+ CD8+, natural killer (NK), and NK T cells]. We also conducted preliminary univariate and multivariate analyses of the variables that affected the efficacy of the treatments.

RESULTS

We found a significantly higher 2-year DFS rate of treatment efficacy in the research group than in the control group, with a statistically lower incidence of adverse events. Both groups showed a reduction in serum tumor markers after treatment but there was no marked intergroup difference. After treatment, the various T-cell subgroup indicators in the control group were significantly lower than those in the research group. The indices of T-cell subsets in the research group showed no significant change from preoperative levels. Univariate analysis revealed a significant correlation between TNM staging, tumor differentiation, and the rates of nonresponse to treatment in CRC patients after surgery. Multivariate results indicated that the treatment approach significantly affected the efficacy of postoperative CRC treatment.

CONCLUSION

We concluded that XELOX + DC-CIK immunotherapy for postsurgical CRC patients offers reduced rates of treatment-induced adverse events, extended 2-year DFS, enhanced immunity, and increased physiological antitumor responses.

Keywords: Analysis of variables affecting outcomes; Cellular immunotherapy; Chemotherapy; Colorectal cancer; Clinical effects

Core Tip: Adjuvant postoperative therapy for colorectal cancer (CRC) maximizes surgical outcomes while significantly reducing CRC-related mortality. This study analyzes the efficacy of the XELOX regimen combined with dendritic cell-cytokine-induced killer (DC-CIK) cell immunotherapy for postoperative CRC patients and the mediating variables, aiming to provide a useful clinical reference to optimize the efficacy of postoperative CRC treatment. Through a comparative analysis of the XELOX chemotherapy regimen vs XELOX regimen plus DC-CIK immunotherapy therapy across multiple outcome and safety indices, including efficacy, adverse event rates, serum tumor marker levels, and T-cell subset levels, the combination regimen is confirmed to offer greater efficacy than a chemotherapy regimen alone, enhancing patient immunity, increasing physiological antitumor activity, and providing improved treatment safety.