中晚期肝细胞癌的化学免疫疗法

The Treatment of Moderately Advanced Carcinoma with Chemo-Immunotherapy

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。结果表明,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40.496(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)。研究结果表明,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确属合理、有效的综合治疗方案。

A comparison of effectiveness of chemo-immunotherapy (CIT) using LAK/CD3AK 1-2 weeks after TACE in 74 patients with no surgical indication and TACE alone in 41 patients with moderately advanced HCC was carried out. The rates of remission between CIT group and TACE alone group were 72.4% and 40.4%(P<0.05) in stage II HCC and 48.9% and 14.3% (P<0.05) in stage III HCC respectively (P<0.05). The 6 and 12 months survival of stage III HCC and 2 years survival rates of stage II of CIT group were 62.2%,46.0% and 48. 3% respectively, significantly higher than those of TACE alone group (23.8%,9.5% and 15% respectively,P<0.05). The rates of extrahepatic metastasis within 12 month of CIT group was 25.9%, significantly lower than that of TACE alone group(58.1%,P<0.05). The results show chemo-immunotherapy is a rational and effective treatment for moderately advanced HCC.