辅助细胞因子诱导的杀伤细胞联合微创治疗增强不可切除肝细胞癌的疗效。

Adjuvant cytokine-induced killer cells with minimally invasive therapies augmented therapeutic efficacy of unresectable hepatocellular carcinoma.

机构信息

Department of Minimal Invasive Intervention, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.

Department of Gastroenterology, Clifford Hospital, Guangzhou, China.

出版信息

J Cancer Res Ther. 2020;16(7):1603-1610. doi: 10.4103/jcrt.JCRT_962_19.

DOI:10.4103/jcrt.JCRT_962_19

PMID:33565506

Abstract

OBJECTIVE

To investigate the safety and therapeutic efficacy of adjuvant cytokine-induced killer (CIK) cells to minimally invasive therapies in unresectable hepatocellular carcinoma (u-HCC).

MATERIALS AND METHODS

Hundred patients diagnosed with having u-HCC in our department from January 1, 2001, to July 31, 2018, were recruited. Forty-three patients received microwave ablation (MWA) and transcatheter arterial chemoembolization (TACE) together with autologous CIK cell treatment (TACE + MWA + CIK group), whereas 57 patients received TACE and MWA only (TACE + MWA group). Postprocedural complications and cumulative therapeutic effects were assessed in all patients. The disease control rate, median survival time (MST), and cumulative survival rate were compared between the cohorts using the Kaplan-Meier method and unpaired Student's t-tests.

RESULTS

The overall response (complete response [CR] + partial response [PR]) rate was 74.42% (32/43) and 77.19% (44/57) for TACE + MWA + CIK and TACE + MWA groups, respectively (P = 0.243). Those of the TACE + MWA + CIK group had better rates of disease control (CR + PR + stable disease) in contrast to the TACE + MWA group (87.72% vs. 79.07%, respectively) but this failed to achieve statistical significance (P = 0.748). Based on the Kaplan-Meier survival graphs, those of the TACE + MWA + CIK groups possessed markedly increased overall survival (41 months vs. 24 months, P = 0.002) and progression-free survival (17 months vs. 10 months, P = 0.023) rates in compared to the TACE + MWA group. Survival rates were raised also TACE + MWA + CIK group than in TACE + MWA group (P = 0.002), with a MST of 6.13 ± 0.83 months and 11.61 ± 1.59 months in the TACE + MWA + CIK and TACE + MWA groups, respectively. Patients in the TACE + MWA + CIK group were not reported to have any severe complications.

CONCLUSION

CIK cell immunotherapy as an adjuvant to TACE and MWA enhanced long-term prognosis and improved quality of life in patients with u-HCC. This regimen may be recommended as a novel treatment regime in u-HCC patients.

摘要

目的

探讨细胞因子诱导的杀伤（CIK）细胞辅助微创治疗不可切除肝细胞癌（u-HCC）的安全性和疗效。

材料与方法

2001 年 1 月 1 日至 2018 年 7 月 31 日，我科共收治 u-HCC 患者 100 例。43 例患者接受微波消融（MWA）和经导管动脉化疗栓塞（TACE）联合自体 CIK 细胞治疗（TACE+MWA+CIK 组），57 例患者仅接受 TACE 和 MWA（TACE+MWA 组）。所有患者均评估术后并发症和累积治疗效果。采用 Kaplan-Meier 法和配对学生 t 检验比较两组患者的疾病控制率、中位生存期（MST）和累积生存率。

结果

TACE+MWA+CIK 组和 TACE+MWA 组的总反应（完全缓解[CR]+部分缓解[PR]）率分别为 74.42%（32/43）和 77.19%（44/57）（P=0.243）。与 TACE+MWA 组相比，TACE+MWA+CIK 组的疾病控制率（CR+PR+稳定疾病）更高（87.72% vs. 79.07%），但差异无统计学意义（P=0.748）。根据 Kaplan-Meier 生存曲线，与 TACE+MWA 组相比，TACE+MWA+CIK 组的总生存率（41 个月 vs. 24 个月，P=0.002）和无进展生存率（17 个月 vs. 10 个月，P=0.023）明显提高。与 TACE+MWA 组相比，TACE+MWA+CIK 组的生存率也有所提高（P=0.002），TACE+MWA+CIK 组和 TACE+MWA 组的 MST 分别为 6.13±0.83 个月和 11.61±1.59 个月。TACE+MWA+CIK 组患者未报告出现任何严重并发症。