Hung Chao-Hung, Lee Chuan-Mo, Wang Jing-Houng, Tung Hung-Da, Chen Chien-Hung, Lu Sheng-Nan
Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
J Gastroenterol Hepatol. 2005 Oct;20(10):1553-9. doi: 10.1111/j.1440-1746.2005.03925.x.
Antiviral therapy for chronic hepatitis C virus (HCV) infection has led to a reduction in the incidence of hepatocellular carcinoma (HCC). The purpose of the present paper was to assess whether antiviral therapy might suppress tumor recurrence and influence overall survival in patients with HCV-related HCC who had complete ablation of nodules by non-surgical treatments.
Twenty patients with three or fewer nodules of HCV-related HCC who were treated with percutaneous tumor ablation and/or transcatheter arterial embolization received combined interferon (IFN; 3 or 5 million units of IFN alpha-2b thrice weekly) plus ribavirin (1000-1200 mg per day) therapy for 24-48 weeks after complete ablation of lesions. During the same period, an additional 40 age- and sex-matched control patients with similar characteristics of tumors (sizes, numbers and treatment modalities) and severity of liver disease were recruited from the HCC database. Both recurrence-free survival and actuarial survival were evaluated.
Of the 20 patients, 16 completed therapy and 10 showed a sustained response with normalization of alanine aminotransferase and negative HCV-RNA at 6 months after therapy completion. Due to severe side-effects experienced by Child B patients, who mostly discontinued antiviral therapy, clinical outcome was analyzed in the Child A treated (n = 16) and control (n = 33) patients. There was no significant difference in the incidence of local recurrence in sustained responders compared with non-responders or control patients (P = 0.174, 0.1284, respectively); but the second recurrence-free interval in the sustained responders was significantly longer than that of non-responders and the control group (P = 0.0141, 0.0243, respectively). Survival in sustained responders was better than in non-responders and control patients (P = 0.0691, 0.0554, respectively).
These results indicate that successful antiviral therapy after non-surgical tumor ablation for HCV-related HCC may lower tumor recurrence rate and prolong survival.
慢性丙型肝炎病毒（HCV）感染的抗病毒治疗已使肝细胞癌（HCC）的发病率有所降低。本文旨在评估抗病毒治疗是否可抑制肿瘤复发，并影响经非手术治疗使结节完全消融的HCV相关性HCC患者的总生存期。
20例HCV相关性HCC结节数为3个或更少的患者接受了经皮肿瘤消融和/或经导管动脉栓塞治疗，在病变完全消融后，接受联合干扰素（IFN；3或5百万单位的IFNα-2b，每周三次）加利巴韦林（每天1000 - 1200毫克）治疗24 - 48周。在此期间，从HCC数据库中另外招募了40例年龄和性别匹配的对照患者，这些患者具有相似的肿瘤特征（大小、数量和治疗方式）以及肝病严重程度。对无复发生存期和精算生存期进行了评估。
20例患者中，16例完成治疗，10例在治疗完成后6个月时丙氨酸转氨酶恢复正常且HCV - RNA呈阴性，并表现出持续应答。由于Child B级患者大多因严重副作用而中断抗病毒治疗，因此对接受治疗的Child A级患者（n = 16）和对照患者（n = 33）的临床结局进行了分析。持续应答者与无应答者或对照患者相比，局部复发率无显著差异（P分别为0.174、0.1284）；但持续应答者的第二次无复发生存期明显长于无应答者和对照组（P分别为0.0141、0.0
