Kawata A, Une Y, Hosokawa M, Wakizaka Y, Namieno T, Uchino J, Kobayashi H
First Department of Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
Am J Clin Oncol. 1995 Jun;18(3):257-62. doi: 10.1097/00000421-199506000-00014.
To determine improved postresection survival in patients with hepatocellular carcinoma, two postoperative protocols were compared: adoptive chemoimmunotherapy versus chemotherapy. Following resection, 24 patients were allocated at random to receive (1) arterial infusion of Adriamycin, recombinant interleukin-2 and lymphokine-activated killer cells or (2) arterial infusion of Adriamycin alone. The spleen was removed at operation and used to prepare lymphokine-activated killer cells. Each group had 12 patients. They were followed until signs of recurrence appeared. The overall survival rates of the patients were 91.7%, 82.9%, and 72.5% at 1, 2, and 3 years, respectively, and slightly higher than would be expected with surgery alone. No statistically significant difference was found between the two groups either in the survival rate (generalized Wilcoxon test, P = .936) or in the cumulative disease free rate (P = .182). However, when patients who had had hepatic resection with negative margin (> or = 1 cm) were separated, the 2-year cumulative disease-free rate in the adoptive chemoimmunotherapy was higher (83.3%, n = 6) than that in chemotherapy (37.5%, n = 8). Toxicity to adoptive chemoimmunotherapy was moderate; no severe side effects were observed. Totally no statistical difference between the two groups was found. Although only one of six patients in adoptive chemoimmunotherapy experienced recurrence after hepatic resection with negative margin, it was not feasible to determine the role of interleukin-2 and lymphokine-activated killer cells. We conclude that the adoptive chemoimmunotherapy in this study is not an ideal adjuvant protocol after hepatic resection.
为确定肝细胞癌患者切除术后生存率的改善情况，比较了两种术后方案：过继性化学免疫疗法与化疗。切除术后，24例患者被随机分配接受：(1) 动脉内输注阿霉素、重组白细胞介素-2和淋巴因子激活的杀伤细胞，或 (2) 仅动脉内输注阿霉素。术中切除脾脏用于制备淋巴因子激活的杀伤细胞。每组12例患者。对他们进行随访直至出现复发迹象。患者1年、2年和3年的总生存率分别为91.7%、82.9%和72.5%，略高于单纯手术预期的生存率。两组在生存率（广义Wilcoxon检验，P = 0.936）或累积无病率（P = 0.182）方面均未发现统计学显著差异。然而，当将切缘阴性（≥1 cm）的肝切除患者分开时，过继性化学免疫疗法组的2年累积无病率（83.3%，n = 6）高于化疗组（37.5%，n = 8）。过继性化学免疫疗法的毒性为中度；未观察到严重副作用。两组之间完全未发现统计学差异。虽然过继性化学免疫疗法组6例切缘阴性的肝切除患者中只有1例出现复发，但确定白细胞介素-2和淋巴因子激活的杀伤细胞的作用并不可行。我们得出结论，本研究中的过继性化学免疫疗法不是肝切除术后理想的辅助方案。
