Department of Health Statistics, The Second Military Medical University, Shanghai, China.
PLoS One. 2012;7(8):e42879. doi: 10.1371/journal.pone.0042879. Epub 2012 Aug 15.
The effectiveness of immunotherapy for postoperative hepatocellular carcinoma patients is still controversial. To address this issue, we did a systemic review of the literatures and analyzed the data with emphasis on the recurrence and survival.
We searched six randomized controlled trials that included adoptive immunotherapy in the postoperative management of hepatocellular carcinoma and compared with non-immunotherapy postoperation. A meta-analysis was carried out to examine one- and 3-year recurrence and survival.
The overall analysis revealed significantly reduced risk of 1-year recurrence in patients receiving adoptive immunotherapy (OR=0.35; 95% CI, 0.17 to 0.71; p=0.003), in that the risk of 3-year recurrence with a pooled OR estimated at 0.31 (95% CI 0.16 to 0.61; p=0.001). However, no statistically significant difference was observed for 3-year survival between groups with adoptive immunotherapy and without adjuvant treatment (OR=0.91; 95% CI, 0.45 to 1.84; P=0.792).
Adjuvant immunotherapy with cytokine induced killer cells or lymphokine activated killer cells may reduce recurrence in postoperative hepatocellular carcinoma patients, but may not improve survival.
免疫疗法在肝癌术后患者中的有效性仍存在争议。为解决这一问题，我们对文献进行了系统回顾，并重点分析了复发和生存数据。
我们检索了六项包含肝癌术后采用过继免疫疗法并与非免疫疗法术后进行比较的随机对照试验。我们进行了荟萃分析，以检查 1 年和 3 年的复发和生存情况。
总体分析显示，接受过继免疫疗法的患者 1 年复发风险显著降低（OR=0.35；95%CI，0.17 至 0.71；p=0.003），3 年复发风险的合并 OR 估计为 0.31（95%CI，0.16 至 0.61；p=0.001）。然而，接受过继免疫疗法和未接受辅助治疗的两组之间，3 年生存率无统计学差异（OR=0.91；95%CI，0.45 至 1.84；P=0.792）。
细胞因子诱导的杀伤细胞或淋巴因子激活的杀伤细胞辅助免疫疗法可能降低肝癌术后患者的复发率，但可能不会改善生存率。
