Abstract
PurposeCellular immunotherapy has appeared to be a promising modality for the treatment of malignant tumor. The objective of this study was to evaluate the efficacy of cellular immunotherapy combined with minimally invasive therapy.MethodsWe searched PubMed, Web of Science and The Cochrane Library through March 2016 for relevant studies. Short-term efficacy (the disease control rate, the control rate of quality life and the AFP descent rate) and long-term efficacy (overall survival (OS) and progression-free survival (PFS) rate) were compared as the major outcome measures. The meta-analysis was performed using Review Manager 5.3.ResultsA total of 1174 references in 3 databases were found of which 19 individual studies with 1774 HCC patients enrolled in this meta-analysis. Meta-analysis results showed that cellular immunotherapy combined with minimally-invasive treatment significantly improved the measures of short-term response (the disease control rate (OR = 5.91, P = 0.007), the control rate of quality lift (OR = 3.38, P = 0.003) and the AFP descent rate (OR = 4.48, P = 0.02)). Also higher 6-month PFS (OR = 2.78, P = 0.05), ≥12-month PFS (OR = 3.56, P<0.00001) rate and 6-month OS (OR = 2.81, P = 0.0009), 12-month OS (OR = 3.05, P<0.00001) and 24-month OS (OR = 3.52, P<0.0001) rate were observed in patients undergoing cellular immunotherapy.ConclusionsThis meta-analysis suggested that cellular immunotherapy is a feasible adjuvant treatment that could be beneficial for the improvement of the clinical outcomes for hepatocellular carcinoma (HCC) patients after minimally invasive treatment, including short-term response and long-term survival.
Highlights
Hepatocellular carcinoma (HCC) is the most common type of hepatobiliary cancer, the fifth common malignant cancer and the third most cause of cancer-related deaths worldwide [1]
Meta-analysis results showed that cellular immunotherapy combined with minimally-invasive treatment significantly improved the measures of short-term response (the disease control rate (OR = 5.91, P = 0.007), the control rate of quality lift (OR = 3.38, P = 0.003) and the AFP descent rate (OR = 4.48, P = 0.02))
Higher 6-month progression free survival (PFS) (OR = 2.78, P = 0.05), !12-month PFS (OR = 3.56, P
Summary
Hepatocellular carcinoma (HCC) is the most common type of hepatobiliary cancer, the fifth common malignant cancer and the third most cause of cancer-related deaths worldwide [1]. The recurrence rate of HCC was still high after conventional radical resection therapies. Not all patients may benefit from hepatectomy because of the high incidence of complications due to chronic liver disease or with intermediate-stage HCC [3,4]. Minimally-invasive treatment has been widely used for patients with unresectable HCC. Transcatheter arterial chemoembolization (TACE) has been found to be an effective method to reduce HCC tumor size and improve overall survival (OS) [5,6]. The recurrence and metastasis after treatment with the TACE-predominant minimally-invasive treatment were still frequent [9]. The prognosis of HCC remained dismal with a low level of survival (5-year survival rate less than 5%) in patients with advanced HCC at diagnosis [10]
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