Qiang Ji1, Yadong Fu, Xiwen Zhu, Lili Wang, Chunyan Ling. 1. Institute of Liver Diseases, Key Laboratory of Liver and Kidney Diseases (Ministry of Education), Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Abstract
PURPOSE: To evaluate the efficacy and safety of radiofrequency ablation (RFA) and transcatheter arterial chemoembolization (TACE) combined with postoperative cytokine-induced killer (CIK) cell immunotherapy in the treatment of primary hepatocellular carcinoma (HCC). METHODS: The clinical data of 116 patients with primary HCC treated in our hospital from March 2016 to January 2018 were collected. 58 patients were treated with RFA+TACE (RFA+TACE group), and the other 58 patients underwent RFA+TACE+CIK cell immunotherapy (RFA+TACE+CIK group). Before and after treatment, the proportions of cluster of differentiation 3+ (CD3+), CD3+CD4+, and CD3+CD8+ T cells, regulatory T cells (Tregs) and natural killer (NK) cells and the CD4+/CD8+ ratio were detected via flow cytometry, and the levels of serum interferon-γ (IFN-γ), interleukin-2 (IL-2) and IL-6 were detected via enzyme-linked immunosorbent assay (ELISA). The incidence of adverse reactions and the quality of life score of patients after treatment were compared between the two groups, and the patient's survival status was recorded through follow-up. RESULTS: After treatment, the levels of CD3+ T cells, CD3+CD4+ T cells, CD4+/CD8+ ratio, Tregs and NK cells were significantly higher, while the level of CD3+CD8+ T cells was significantly lower in RFA+TACE+CIK group than those in RFA+TACE group. After treatment, the level of alpha fetoprotein (AFP) obviously declined in both groups compared with that before treatment, and it was significantly lower in RFA+TACE+CIK group than that in RFA+TACE group. After treatment, the scores of the QLQ-C30 questionnaire were all significantly higher in RFA+TACE+CIK group than those in RFA+TACE group. After treatment, the general functioning score rose from (58.55±11.82) and (59.39±10.97) points to (74.74±15.58) and (68.42±14.85) points, respectively, in RFA+TACE+CIK group and RFA+TACE group, and it was significantly higher in RFA+TACE+CIK group than that in RFA+TACE group. According to the follow-up results, the mean overall survival (OS) of patients was (42.1±5.6) months and (37.8±4.8) months, and the 5-year OS rate was 29.3% (17/58) and 13.8% (8/58), respectively, in RFA+TACE+CIK group and RFA+TACE group. The results of log-rank test showed that the OS in RFA+TACE+CIK group was significantly superior to that in RFA+TACE group. CONCLUSIONS: RFA and TACE combined with postoperative autologous CIK cell reinfusion have significant efficacy in the treatment of primary HCC, which can enhance the immune function, improve the postoperative quality of life and raise the survival rate of patients, with tolerable adverse reactions.
PURPOSE: To evaluate the efficacy and safety of radiofrequency ablation (RFA) and transcatheter arterial chemoembolization (TACE) combined with postoperative cytokine-induced killer (CIK) cell immunotherapy in the treatment of primary hepatocellular carcinoma (HCC). METHODS: The clinical data of 116 patients with primary HCC treated in our hospital from March 2016 to January 2018 were collected. 58 patients were treated with RFA+TACE (RFA+TACE group), and the other 58 patients underwent RFA+TACE+CIK cell immunotherapy (RFA+TACE+CIK group). Before and after treatment, the proportions of cluster of differentiation 3+ (CD3+), CD3+CD4+, and CD3+CD8+ T cells, regulatory T cells (Tregs) and natural killer (NK) cells and the CD4+/CD8+ ratio were detected via flow cytometry, and the levels of serum interferon-γ (IFN-γ), interleukin-2 (IL-2) and IL-6 were detected via enzyme-linked immunosorbent assay (ELISA). The incidence of adverse reactions and the quality of life score of patients after treatment were compared between the two groups, and the patient's survival status was recorded through follow-up. RESULTS: After treatment, the levels of CD3+ T cells, CD3+CD4+ T cells, CD4+/CD8+ ratio, Tregs and NK cells were significantly higher, while the level of CD3+CD8+ T cells was significantly lower in RFA+TACE+CIK group than those in RFA+TACE group. After treatment, the level of alpha fetoprotein (AFP) obviously declined in both groups compared with that before treatment, and it was significantly lower in RFA+TACE+CIK group than that in RFA+TACE group. After treatment, the scores of the QLQ-C30 questionnaire were all significantly higher in RFA+TACE+CIK group than those in RFA+TACE group. After treatment, the general functioning score rose from (58.55±11.82) and (59.39±10.97) points to (74.74±15.58) and (68.42±14.85) points, respectively, in RFA+TACE+CIK group and RFA+TACE group, and it was significantly higher in RFA+TACE+CIK group than that in RFA+TACE group. According to the follow-up results, the mean overall survival (OS) of patients was (42.1±5.6) months and (37.8±4.8) months, and the 5-year OS rate was 29.3% (17/58) and 13.8% (8/58), respectively, in RFA+TACE+CIK group and RFA+TACE group. The results of log-rank test showed that the OS in RFA+TACE+CIK group was significantly superior to that in RFA+TACE group. CONCLUSIONS: RFA and TACE combined with postoperative autologous CIK cell reinfusion have significant efficacy in the treatment of primary HCC, which can enhance the immune function, improve the postoperative quality of life and raise the survival rate of patients, with tolerable adverse reactions.