Whether the systemic transcatheter arterial chemoembolization ought to combine with adoptive T lymphocytes for the advanced-stage hepatocellular carcinoma: a comparative study
CAO Liang1,LI Wei1,SHENG Jun1,PENG Xun1,PENG Yong2,GUO Congshan2,TIAN Ru2
1.Department of Medical Oncology, Qinhuangdao No.3 Hospital, Qinhuangdao 066000, China; 2. Department of Biomedical Engineering, Yanshan University, Qinhuangdao 066004, China
Abstract：Objective To study the different affects of TACE alone and TACE combined with adoptive T lymphocytes on the peripheral T lymphocyte subsets and Treg cells for advanced hepatocellular carcinoma(HCC). Methods 114 patients with advanced stage HCC were recruited, 56 patients were treated with TACE followed by adoptive T lymphocytes treatment,and 58 patients were treated with TACE only as a control group. Each patient was treated once a month, successive 3 times were a course of treatment. The duration of the observation was 2 years. The progress free survival(PFS) and overall survival(OS), serum levels of AFP, T lymphocyte sunsets and Treg cells in peripheral blood of advanced HCC patients were found out before and after the treatments. Results The short-term responses in the 2 groups were similar. There was also no significant difference in the reduction rates of AFP between these two groups. The 6 months, 1 year, and 2 years PFS rates were 71.4%, 23.2%, 5.4% in combination group, and 65.5%, 31.0%, 3.4% in control group. The median TTP (time to progression)was 8 months (95% confidence interval CI,8-11 months) for combination group and 5 months(95% confidence interval CI,6- 9 months) for control group. The proportion of 6 months, 1 year, and 2 years OS were 89.2%, 71.4% and 60.7% in combination group, while in control group they were 70.6%, 41.4%, 17.2%(P<0.05) , respectively. The median survival time was 18 months(95% CI,16-20 months)in combination group and 11 months(95% CI,9-13 months)in control group. In the study group, the percentage of CD4+ increased from(51.27?4.85)% to(54.51?5.03)% (P<0.05), CD8+ and Treg cells decreased from (40.87?3.26)%,(6.36?0.98)% to (37.24?3.56)%,(3.89?0.31)% (P<0.05), respectively. The rates of CD4+/CD8+ increased greatly(P<0.05). There was no significant difference compared between before and after treatment in the control group. Conclusions Adjuvant immunotherapy with adoptive T lymphocytes may prolong the PFS and OS in advanced HCC patients, and there is a statistically significant difference. It can improve immunological status as well as the efficacy of TACE in these patients. It may also play an important role in reducing the recurrence and metastases in HCC patients.
2014, Vol. 25 
