中晚期肝细胞癌的化学免疫疗法

CHEMO-IMMUNOTHERAPY OF MID-ADVANCED HEPATOCELLULAR CARCINOMA: A COMPARISIVE STUDY OF 115 CASES

目的和方法对７４例无手术切除指征的中晚期肝细胞癌（ＨＣＣ）患者采用化学免疫治疗（ＣＩＴ），即经肝动脉化学栓塞治疗后１～２周，序贯地施行ＬＡＫ或ＣＤ３ＡＫ过继免疫治疗，并以同期单用经肝动脉化学栓塞治疗的４１例相同患者作对比。结果化学免疫治疗组和经肝动脉化学栓塞治疗组的Ⅱ、Ⅲ期ＨＣＣ患者的缓解率差异显著，分别为７２．４％与４０．４％（Ｐ＜０．０５）和４８．９％与１４．３％（Ｐ＜０．０５）。化学免疫治疗和经肝动脉化学栓塞治疗组相比，Ⅲ期ＨＣＣ患者的半年、１年生存率和Ⅱ期患者的２年生存率差异也显著，分别为６２．２％与２３．８％（Ｐ＜０．０５）、４６．０％与９．５％（Ｐ＜０．０５）以及４８．３％与１５．０％（Ｐ＜０．０５）。化学免疫治疗组１年内肝外转移发生率为２５．９％（１５／５８），明显较经肝动脉化疗栓塞治疗组（５８．１％，１８／３１）为低（Ｐ＜０．０５）。结论化学免疫治疗这一有机序贯结合在治疗中晚期肝细胞癌患者方面属合理、有效的综合治疗方案。

and Methods Clinical effects of chemo-immunotherapy (CIT) with LAK/CD3AK after 1 ￣2 weeks of transarterial chemoembolization (TACE) on 74 patients with mid-advanced hepato cellular carcinoma (HCC) without opemtive indications were compared with those of only TACE on 41patients. Results The remission rate between CIT group and TACE group in stage Ⅱ and Ⅲ HCC was 48.90% and 14.3% (P<0.05), respectively. 72.4% and 40.4% (P<0.05), 12 month survival rate in stage Ⅲ HCC and 2 year surrival rate in stge Ⅱ HCC of CIT group were 62.2%, 46.0% and 48.3%,respectively. Comparing with those of TACE group (23.8%, 9.5% and 15.0%), all showed signficant different (P<0.05). The rate of parahepatic metastasis with 12 months of CIT group was 25.9% (15/58),significantly lower than that(58.1%, 18/31) of TACE group. Conclusions The results showed that chemo-immunotherapy is a rational and effective treatment for mid-advanced HCC.