ADJUVANT CHEMOIMMUNOTHERAPY FOR HEPATOCELLULAR-CARCINOMA PATIENTS - ADRIAMYCIN, INTERLEUKIN-2, AND LYMPHOKINE-ACTIVATED KILLER-CELLS VERSUSADRIAMYCIN ALONE

To determine improved postresection survival in patients with hepatoce llular carcinoma, two postoperative protocols were compared: adoptive chemoimmunotherapy versus chemotherapy. Following resection, 24 patien ts were allocated at random to receive (1) arterial infusion of Adriam ycin, recombinant interleukin-2 and lymphokine-activated killer cells or (2) arterial infusion of Adriamycin alone. The spleen was removed a t operation and used to prepare lymphokine-activated killer cells. Eac h group had 12 patients. They were followed until signs of recurrence appeared. The overall survival rates of the patients were 91.7%, 82.9% , and 72.5% at 1, 2, and 3 years, respectively, and slightly higher th an would be expected with surgery alone. No statistically significant difference was found between the two groups either in the survival rat e (generalized Wilcoxon test, P = .936) or in the cumulative disease f ree rate (P = .182). However, when patients who had had hepatic resect ion with negative margin (21 cm) were separated, the 2-year cumulative disease-free rate in the adoptive chemoimmunotherapy was higher (83.3 %, n = 6) than that in chemotherapy (37.5%, n = 8). Toxicity to adopti ve chemoimmunotherapy was moderate; no severe side effects were observ ed. Totally no statistical difference between the two groups was found . Although only one of six patients in adoptive chemoimmunotherapy exp erienced recurrence after hepatic resection with negative margin, it w as not feasible to determine the role of interleukin 2 and lymphokine- activated killer cells. We conclude that the adoptive chemoimmunothera py in this study is not an ideal adjuvant protocol after hepatic resec tion.