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射频消融后长期干扰素治疗对治疗丙型肝炎相关肝细胞癌患者有效。

Long-term interferon therapy after radiofrequency ablation is effective in treating patients with HCV-associated hepatocellular carcinoma.

出版信息

Hepatol Int. 2010 Sep 24;5(1):559-66. doi: 10.1007/s12072-010-9214-2.

Abstract

PURPOSE

This study investigates the usefulness of long-term interferon (IFN) therapy following radiofrequency ablation (RFA) for HCV-associated hepatocellular carcinoma (HCC).

METHODS

This is a retrospective observational study. Patients underwent pegylated IFN-α/ribavirin combination therapy for 48 weeks and then were maintained on IFN-α administration on average for 68 weeks (mean total duration 116 weeks). Patients who underwent IFN monotherapy were maintained on IFN administration on average for 78 weeks.

RESULTS

There were biases in the background factors between the IFN and non-IFN groups. Therefore, a covariate adjustment was performed using the propensity score. An analysis of 20-matched patients from each group showed the 5-year cumulative survival rate was higher in the IFN group than in the non-IFN group (100 and 76%, respectively), and the 3-year cumulative recurrence rate was significantly lower in the IFN group than in the non-IFN group (38.0 and 64.2%, respectively). In 14 patients (i.e., IFN responders), the serum alanine aminotransferase (ALT) level remained normalized at 30 IU/mL or lower, regardless of disappearance of serum HCV RNA. In these patients, the cumulative recurrence rate was low, the hazard ratio was 0.158 (95% confidence interval = 0.045-0.561, P = 0.004), and the serum albumin level was retained.

CONCLUSION

These results show the importance of maintaining the liver function and suggest that long-term IFN administration after RFA inhibits recurrence and contributes to an improved outcome in patients (in particular, IFN responders) who initially develop HCC.

摘要

目的

本研究旨在探讨射频消融(RFA)后长期干扰素(IFN)治疗对丙型肝炎相关肝细胞癌(HCC)的疗效。

方法

这是一项回顾性观察性研究。患者接受聚乙二醇化 IFN-α/利巴韦林联合治疗 48 周,然后平均接受 IFN-α治疗 68 周(平均总疗程 116 周)。接受 IFN 单药治疗的患者平均接受 IFN 治疗 78 周。

结果

IFN 组和非 IFN 组的背景因素存在偏倚。因此,使用倾向评分进行了协变量调整。对每组 20 例匹配患者的分析显示,IFN 组的 5 年累积生存率高于非 IFN 组(分别为 100%和 76%),IFN 组的 3 年累积复发率显著低于非 IFN 组(分别为 38.0%和 64.2%)。在 14 例(即 IFN 应答者)患者中,血清丙氨酸氨基转移酶(ALT)水平保持在 30IU/mL 或更低,无论血清 HCV RNA 是否消失。在这些患者中,累积复发率较低,风险比为 0.158(95%置信区间为 0.045-0.561,P=0.004),且血清白蛋白水平得以维持。

结论

这些结果表明维持肝功能的重要性,并提示 RFA 后长期 IFN 给药可抑制复发,改善初始发生 HCC 的患者(尤其是 IFN 应答者)的预后。

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