Zhao Hui, Zheng Min, Wang Kun, Wang Lianmin, He Haiyu, Wang Meilian, Shi Yanmei, Huang Songquan, Ji Fengming, Li Xiao, Zhu Hong, Wang Lin, Zhang Xiaowen, Shi Xueyang, Zhao Songling, Fu Bimang, Wu Tao
Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
Department of Colorectal Surgery, The Third Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
J Cancer Res Ther. 2018;14(4):807-814. doi: 10.4103/jcrt.JCRT_858_17.
Adoptive immunotherapy (AIT) has been adopted as an adjuvant treatment for hepatocellular carcinoma (HCC) patients after curative therapy. However, the outcomes of AIT remain controversial.
The purpose of this study is to analyze the safety and efficacy of AIT with the recurrence rate and mortality.
We identified eight randomized controlled trials (RCTs) that adopted AIT to HCC after curative treatments. A meta-analysis was carried out to assess the recurrence rate and mortality.
Eight RCTs with 964 patients were included in the study. The overall analysis showed that AIT treatment can not only decrease the 1-year (risk ratio [RR] =0.59, 95% confidence interval [95% CI] = 0.48-0.72, P < 0.00001), 2-year (RR = 0.69, 95% CI = 0.60-0.79, P < 0.00001), and 3-year (RR = 0.82, 95% CI = 0.74-091, P = 0.0001) recurrence, but also decrease the 1-year (RR = 0.43, 95% CI = 0.30-0.62, P = 0.00001), 2-year (RR = 0.56, 95% CI = 0.46-0.74, P < 0.00001), and 3-year (RR = 0.85, 95% CI = 0.73-0.99, P = 0.03) mortality. The results also indicate that the group of lymphokine-activated killer (LAK) cells showed lower pooled RR values compared to the group of cytokine-induced killer cells among every subgroups. However, the AIT treatment failed to affect the 5-year recurrence rate and mortality (P > 0.05).
This review provides available evidences that AIT, especially the treatment of LAK, can be used to decrease the early recurrence and mortality of postoperative HCC but may not the long term.
过继性免疫疗法（AIT）已被用作肝细胞癌（HCC）患者根治性治疗后的辅助治疗。然而，AIT的疗效仍存在争议。
本研究旨在分析AIT的安全性和有效性以及复发率和死亡率。
我们确定了八项在根治性治疗后对HCC采用AIT的随机对照试验（RCT）。进行荟萃分析以评估复发率和死亡率。
该研究纳入了八项RCT，共964例患者。总体分析表明，AIT治疗不仅可以降低1年（风险比[RR]=0.59，95%置信区间[95%CI]=0.48 - 0.72，P<0.00001）、2年（RR = 0.69，95%CI = 0.60 - 0.79，P<0.00001）和3年（RR = 0.82，95%CI = 0.74 - 0.91，P = 0.0001）的复发率，还能降低1年（RR = 0.43，95%CI = 0.30 - 0.62，P = 0.00001）、2年（RR = 0.56，95%CI = 0.46 - 0.74，P<0.00001）和3年（RR = 0.85，95%CI = 0.73 - 0.99，P = 0.03）的死亡率。结果还表明，在各个亚组中，淋巴因子激活的杀伤细胞（LAK）组的合并RR值低于细胞因子诱导的杀伤细胞组。然而，AIT治疗未能影响5年复发率和死亡率（P>0.05）。
本综述提供了可用证据表明AIT，尤其是LAK治疗，可用于降低术后HCC的早期复发率和死亡率，但可能无法降低长期复发率和死亡率。
