Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.
Department of Medicine, Chang-Gung University College of Medicine, Taoyuan, Taiwan.
Cancer Rep (Hoboken). 2021 Feb;4(1):e1294. doi: 10.1002/cnr2.1294. Epub 2020 Oct 13.
Therapeutic effect and immunosuppressor cell alteration in adding transcatheter arterial chemoembolization (TACE) to sorafenib for advanced stage hepatocellular carcinoma (HCC) remain unclear.
To examine the therapeutic effect and immunosuppressor cell alteration in adding TACE to sorafenib.
Forty-four advanced stage HCC patients were divided into group A (n = 17) treated by sorafenib (400-600 mg/day) alone and group B patients (n = 27) treated by sorafenib and TACE. The frequency of regulatory T-cells and myeloid-derived suppressor cells (MDSC), and patients' outcomes were examined. Advanced HCC patients' survival was improved by adding TACE to sorafenib if N/L was reduced from ≥2.5 to <2.5 by TACE.
The median (interquartile) follow-up for all patients was 8.5 (3.5 to 15.5) with a range from 1 to 71 months. The median (interquartile) survival was 5.0 (2.3-11.3) months for group A and 11.0 (5.0-19.0) months for group B patients (P = .024). In group A, the patients (n = 8) with neutrophil-to-lymphocytes ratio (N/L) < 2.5 had better survival than the patients (n = 9) with N/L ≥ 2.5 (P = .006). In group B, 6 of 13 patients with N/L ≥ 2.5 had N/L reduction to <2.5 after combination therapy of sorafenib and TACE, and their 6-month, 1-year and 2-year survival were improved (P = .013). For immune cell examination, the frequency of CD4 and CD8 T-lymphocytes, regulatory T-cell and MDSC were not altered by sorafenib treatment. However, actual number of lymphocytes had a tendency to increase (from 978.5 ± 319.4/mm prior to treatment to 1378.0 ± 403.3/mm , P = .086) for the patients with N/L reduction.
Immunosuppressor cells were not altered by sorafeinb. Patients' survival was improved if N/L ≥ 2.5 was reduced to <2.5 by TACE.
经导管动脉化疗栓塞术（TACE）联合索拉非尼治疗晚期肝细胞癌（HCC）的疗效和免疫抑制细胞改变仍不清楚。
研究 TACE 联合索拉非尼对晚期 HCC 的疗效和免疫抑制细胞的影响。
将 44 例晚期 HCC 患者分为 A 组（n = 17），接受索拉非尼（400-600mg/天）单独治疗；B 组（n = 27）接受索拉非尼和 TACE 联合治疗。检测调节性 T 细胞和髓源性抑制细胞（MDSC）的频率，以及患者的预后。如果 TACE 将中性粒细胞与淋巴细胞比值（N/L）从≥2.5 降低至<2.5，则晚期 HCC 患者的生存可通过添加 TACE 联合索拉非尼得到改善。
所有患者的中位（四分位间距）随访时间为 8.5（3.5-15.5）个月，范围为 1-71 个月。A 组患者的中位（四分位间距）生存期为 5.0（2.3-11.3）个月，B 组为 11.0（5.0-19.0）个月（P=0.024）。在 A 组中，N/L<2.5 的患者（n=8）的生存情况优于 N/L≥2.5 的患者（n=9）（P=0.006）。在 B 组中，13 例 N/L≥2.5 的患者中有 6 例在接受索拉非尼联合 TACE 治疗后 N/L 降低至<2.5，其 6 个月、1 年和 2 年的生存率得到改善（P=0.013）。对于免疫细胞检查，N/L 降低的患者（n=10），CD4 和 CD8 T 淋巴细胞、调节性 T 细胞和 MDSC 的频率未发生改变。然而，淋巴细胞的实际数量有增加的趋势（从治疗前的 978.5±319.4/mm 增加到治疗后的 1378.0±403.3/mm ，P=0.086）。
索拉非尼未改变免疫抑制细胞。如果 TACE 将 N/L≥2.5 降低至<2.5，则患者的生存可得到改善。
