DC-CIK/CIK As An Adjunctive Therapy For Hepatocellular Carcinoma

ObjectiveTo evaluate the efficacy and safety of cytokine-induced killer cell（CIK）in the treatment of primary carcinoma of the liver.MethodsWe searched databases including CBM,CNKI,Wangfang Data,VIP,Chinese clinical trial registry,PubMed,Embase,Cochrane and Clinicaltrail.gov.The retrieval period was from the establishment of the database to December 2019,in both Chinese and English languages,and all randomized controlled trials on DC-CIK/CIK cell-assisted treatment of hepatocellular carcinoma were retrieved,with preference given to recent study.The studies was screened by two reviewers in strict accordance with the inclusion criteria and exclusion criteria,and the studies was screened and included using the cochrane-collaboration RCT risk assessment tool.ResultsA total of 13 studies were included,all of which were randomized controlled trials（RCTS）,except for Wang^[10]semi-randomized controlled trial（quasi-RCTS）.All of them were of high quality.A total of 1392 patients with primary liver cancer were included in the literature,of which 716 were in the CIK group and 676were in the control group.The meta-analysis results showed that,compared with the basic treatment group alone,the OS of the CIK-assisted treatment group（HR=0.67,95%CI[0.56,0.80],P<0.0001）;DFS（HR=0.60,95%CI[0.37,0.99],P=0.04）;RFS(HR=0.63,95%CI[0.44,0.90],P=0.01;and RR（OR=2.11,95%CI[1.32,3.37],P=0.002）;the DCR（OR=3.02,95%CI[1.38,6.59],P=0.006）;and the improvement rate of KPS（OR=2.52,95%CI[1.33,4.80],P=0.005）were all higher than the control group.Among the adverse events,the incidence of fever,headache,gastrointestinal symptoms and abnormal liver function in the combined treatment group was not statistically significant compared with the control group.The differences in the percentage changes of peripheral blood AFP and T cell subsets were also statistically significant.ConclusionCIK as an adjunctive therapy for hepatocellular carcinoma can improve the overall survival rate,disease-free survival rate,relapse-free survival rate,clinical response rate,disease control rate and quality of life improvement rate of patients with hepatocellular carcinoma.The symptoms of adverse reactions were mild,and there was no statistically significant difference between the incidence and the control group.It can reduce the peripheral blood AFP content of patients,improve the immune function of patients.