目的:观察多靶点抗原肽自体免疫细胞技术(multiple antigen stimulating cellular therapy, MASCITM)联合肝动脉栓塞化疗(transcatheter arterial chemoembolization,TACE)治疗原发性肝细胞癌(hepatocellular carcinoma,HCC)的临床疗效。方法:回顾性分析2010年8月至2015年3月南方医院感染内科暨肝病中心收治的66例接受TACE治疗的HCC患者,按是否联合MASCITM治疗分为联合治疗组(32例)和单纯TACE组(34例),主要观察指标为两组患者的无进展生存期(PFS)和总生存期(OS)。结果:联合治疗组0.5、1、2年无进展生存率分别为68.8%、37.5%和25.0%,单纯TACE组分别为50%、11.8%和2.9%,两组中位PFS分别为9.5和5.5个月(P〈0.01)。联合治疗组0.5、1、2年的总生存率分别为81.3%、65.6%和406%,单纯TACE组分别为91.2%、47.1%和23.5%,两组中位OS分别为19.5个月和10.5个月(P<0.05)。是否接受MASCITM治疗、肝门静脉侵犯、治疗前AFP水平、ECOG评分是影响HCC患者PFS的独立预后因素,而是否接受MASCITM治疗、肝门静脉侵犯、治疗前总胆红素水平是影响OS的独立预后因素。结论: MASCITM联合TACE治疗可提高HCC患者的临床疗效,明显延长PFS和OS。
Objective:To observe the clinical efficacy of MASCITM (multiple antigen stimulating cellular therapy) combined with transcatheter arterial chemoembolization (TACE) on primary hepatocellular carcinoma (HCC). Methods:The clinical data of 66 HCC patients with TACE during August 2010 to March 2015 in the Department of Infectious Diseases (Center of Liver Disease) of Nanfang Hospital were retrospectively analyzed. The patients were divided into combination group (TACE+ MASCITM treatment) (32 patients) and TACE group (34 patients). The progression-free survival (PFS) and overall survival (OS) were evaluated in the two groups as main outcome measures. Results:The six-month, 1-year, 2-year PFS rates were 68.8%, 37.5%, 25% in combination group and 50%, 11.8%, 2.9% in TACE group, respectively. The median PFS was 9.5 months in combination group compared with 5.5 months in TACE group(P〈0.01). The six-month, 1-year, 2-year OS rates were 81.3%, 65.6%, 40.6% in combination group and 91.2%, 47.1%, 23.5% in TACE group, respectively. The median OS was 19.5 months in combination group compared with 10.5 months in TACE group (P〈0.05). MASCITM, portal vein invasion, pretreatment serum AFP level and ECOG performance status were the independent prognostic factors for PFS, while MASCITM, portal vein invasion and pretreatment serum TBIL level were the independent prognostic factors for OS. Conclusion: MASCITM combined with TACE could robustly improve the clinical efficacy, and obviously prolong the PFS and OS for HCC patients.