A randomized, controlled trial of postoperative adjuvant cytokine-induced killer cells immunotherapy after radical resection of hepatocellular carcinoma
A randomized, controlled trial of postoperative adjuvant cytokine-induced killer cells immunotherapy after radical resection of hepatocellular carcinoma
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DOI：
10.1016/j.dld.2008.04.007
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发表时间：
2009-01-01
影响因子：
4.5
通讯作者：
Kong, Da-Lu
中科院分区：
文献类型：
--
作者：
Dong, Hui;Li, Qiang;Kong, Da-Lu
背景肝细胞癌对常规的化疗和放疗具有抵抗力，根治性切除术后复发率高。肝癌的辅助免疫治疗是一种很有前途的治疗方法。探讨肝癌根治性切除术后应用苦参碱诱导的杀伤细胞辅助免疫治疗对预后的影响。从2000年1月至2002年1月，我们收集了127例符合选择标准的患者，并将其随机分为3组。CIK-1组41例，CIK-Ⅱ组43例，在肿瘤根治术后，分别给予3个疗程和6个疗程的CIK诱导的杀伤细胞免疫治疗。另43例患者未接受术后辅助治疗（对照组）。比较3组患者的1、3、5年无瘤生存率和总生存率。Log-rank检验显示CIK-Ⅰ组（p =0.001）和CIK-Ⅱ组（p=0.004）的无病生存率显著高于对照组。CIK-I组和CIK-II组之间没有发现统计学显著性（p=0.345）。考克斯回归分析提示治疗方式是复发的危险因素。三组患者的总生存率差异无统计学意义。肝癌根治性切除术后应用苦参碱诱导的杀伤细胞进行免疫治疗可预防复发/转移。但是，它不能提高整体生存率。(C)2008年意大利胃肠病学编辑由爱思唯尔有限公司出版。保留所有权利。
Background. With a resistance to conventional chemotherapy and radiotherapy, hepatocellular carcinoma has a high recurrence rate after radical resection. Adjuvant immunotherapy is a promising treatment for hepatocellular carcinoma.Aim. To evaluate the effect of adjuvant immunotherapy with cytokine-induced killer cells on the prognosis of hepatocellular carcinoma after radical resection.Patients and methods. From January 2000 to January 2002, we collected 127 patients that met the selection criteria and randomly divided them into 3 groups. After radical resection of the tumor, immunotherapy with cytokine-induced killer cells was per-formed for 3 courses in 41 patients (CIK-1 group) and 6 courses in 43 patients (CIK-II group). The other 43 patients received no postoperative adjuvant therapy (the control group). The 1-, 3-, and 5-year disease free survival rates and the overall survival were compared among the 3 groups.Results. The log-rank test showed that the disease-free survival rates were significantly higher in CIK-I group (p =0.001) and CIK-II group (p=0.004) than in the control group. No statistical significance was found between CIK-I group and CIK-II group (p=0.345). Cox regression suggested that treatment modality was a risk factor for recurrence. No statistical significance was found in the overall survival among the three groups.Conclusions. Postoperative immunotherapy with cytokine-induced killer cells may prevent recurrence/metastasis after radical resection of hepatocellular carcinoma. However, it cannot improve the overall survival. (C) 2008 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.