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目的:评估肝癌方联合细胞免疫治疗晚期原发性肝细胞癌(HCC)的疗效和安全性。方法:回顾性分析2010年1月至2015年12月以肝癌方加减联合细胞免疫治疗以及单纯细胞免疫治疗的晚期HCC患者60例,分别为32例、28例。按照RECIST 1.1版标准评估疗效,按照《抗癌药急性及亚急性毒性反应分度标准(WHO标准)》评估不良反应。结果:58例可评价疗效,客观有效率(ORR)及疾病控制率(DCR)分别为25.9%和77.6%;中位生存期为34个月,累积1年生存率为77.6%,2年生存率为62.1%,3年生存率为50.0%。单纯细胞免疫治疗与肝癌方加减联合细胞免疫治疗的ORR、DCR及中位生存期分别为22.2%、66.7%;29.0%、90.3%;18个月、46个月,DCR及中位生存期差异均有统计学意义(P<0.05)。两组不良反应发生率比较,发热、恶心呕吐及腹泻方面差异有统计学意义(P<0.05)。结论:细胞免疫治疗晚期HCC有较好的临床疗效,不良反应可耐受;肝癌方加减联合细胞免疫治疗HCC临床疗效优于单纯细胞免疫治疗。
Objective: To evaluate the efficacy and safety of hepatocellular carcinoma combined with cellular immunotherapy in the treatment of advanced primary hepatocellular carcinoma (HCC). Methods: From January 2010 to December 2015, 60 patients with advanced HCC who were treated with hepatocellular carcinoma plus cytotoxic immunotherapy and simple cell immunotherapy were retrospectively analyzed. They were 32 and 28 respectively. According to RECIST 1.1 standard assessment of efficacy, in accordance with “anti-cancer drugs acute and subacute toxicological response indexing standard (WHO standards)” to assess adverse reactions. Results: The evaluable curative effect, objective and effective rate (ORR) and disease control rate (DCR) were 25.9% and 77.6% respectively in 58 patients. The median survival time was 34 months and the cumulative 1-year survival rate was 77.6% The rate was 62.1% and the 3-year survival rate was 50.0%. The ORR, DCR and median survival of simple cell immunotherapy plus hepatocellular carcinoma combined with cellular immunotherapy were 22.2%, 66.7%, 29.0%, 90.3% respectively. The 18-month and 46-month DCR and median survival The differences were statistically significant (P <0.05). The incidence of adverse reactions in the two groups compared with fever, nausea, vomiting and diarrhea differences were statistically significant (P <0.05). Conclusions: The cellular immunotherapy of advanced HCC has good clinical curative effect and adverse reactions are tolerable. The curative effect of HCC combined with CTC on HCC is better than pure cellular immunotherapy.