Departments of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
Digestion. 2011;83(4):275-82. doi: 10.1159/000320377. Epub 2011 Feb 1.
Sorafenib has become the treatment standard for patients with advanced hepatocellular carcinoma (HCC). It is not clear whether patients with advanced liver function impairment (Child B) and patients undergoing additional locoregional therapy may tolerate treatment with sorafenib and benefit. We aimed to evaluate the tolerability and efficiency of sorafenib in patients with advanced HCC and different stages of liver cirrhosis, and in combination with locoregional therapy.
In 50 patients with advanced HCC treated with sorafenib tolerability and efficiency of the therapy with respect to stage of liver cirrhosis, existence of extrahepatic tumor spread, and additional locoregional therapy were evaluated.
Fifty patients with advanced HCC were treated with sorafenib, and 13 received additional locoregional therapy. Tolerability of the systemic treatment was moderate in all patients, with no significant differences between the subgroups, while the median survival was better in patients with Child A than Child B cirrhosis.
Tolerability and toxicity of a systemic treatment with sorafenib are moderate in patients with liver cirrhosis in Child A or B. Prospective randomized studies are required to evaluate the efficacy and tolerability of combined systemic and locoregional treatment approaches in patients with advanced HCC.
索拉非尼已成为治疗晚期肝细胞癌（HCC）的标准治疗方法。目前尚不清楚肝功能失代偿（Child B）的晚期患者和接受额外局部区域治疗的患者是否能够耐受索拉非尼治疗并从中获益。我们旨在评估索拉非尼在不同肝硬化阶段、合并局部区域治疗的晚期 HCC 患者中的耐受性和疗效。
在 50 例接受索拉非尼治疗的晚期 HCC 患者中，评估了肝硬化阶段、肝外肿瘤扩散、额外局部区域治疗与治疗耐受性和疗效的关系。
50 例晚期 HCC 患者接受了索拉非尼治疗，其中 13 例接受了额外的局部区域治疗。所有患者的系统治疗耐受性均为中度，亚组间无显著差异，而 Child A 级肝硬化患者的中位生存期优于 Child B 级肝硬化患者。
Child A 或 B 级肝硬化患者对索拉非尼的系统治疗具有中等的耐受性和毒性。需要进行前瞻性随机研究，以评估晚期 HCC 患者联合系统和局部区域治疗方法的疗效和耐受性。
