Hiramine Yasunari, Uto Hirofumi, Imamura Yasushi, Tabu Kazuaki, Baba Yoshirou, Hiwaki Takuya, Sho Yukihiko, Tahara Kenji, Higashi Hirofumi, Tamai Tutomu, Oketani Makoto, Ido Akio, Tsubouchi Hirohito
Department of Internal Medicine, Kagoshima Kouseiren Hospital, Kagoshima 890-0061;
Exp Ther Med. 2011 May;2(3):433-441. doi: 10.3892/etm.2011.237. Epub 2011 Mar 21.
Sorafenib is a kinase-targeted drug that has high efficacy for advanced hepatocellular carcinoma (HCC). The aim of the present study was to determine whether sorafenib is more effective than hepatic arterial infusion chemotherapy (HAIC) for HCC. Twenty patients treated with sorafenib (sorafenib group) initiated at 800 mg/day and 45 patients treated with HAIC (HAIC group) for unresectable Child-Pugh A advanced HCC were investigated retrospectively. The treatment effect was assessed using the Response Evaluation Criteria in Solid Tumors (RECIST). As a result, the overall response rate was significantly lower in the sorafenib group than in the HAIC group (P=0.03), while the disease control and survival rates did not differ between the two groups. In the sorafenib group, treatment was discontinued in 19 patients, including 12 due to side effects. In subgroups of patients treated with sorafenib, the survival rate was significantly lower in patients (n=11) administered sorafenib for <60 days compared to those (n=9) treated for ≥60 days. A shorter treatment period (<60 days) was an independent risk factor for unfavorable survival [hazard ratio (HR), 3.34; 95% confidence interval (CI), 1.45-7.66 vs. HAIC], while survival in patients treated with sorafenib for ≥60 days did not differ from those treated with HAIC (HR, 0.79; 95% CI, 0.27-2.34). In conclusion, the disease control and survival rates of patients treated with sorafenib for advanced HCC were comparable to such rates in patients treated with HAIC. However, the prognosis was poor when long-term sorafenib treatment was not possible due to side effects, demonstrating the importance of patient selection for sorafenib treatment.
索拉非尼是一种激酶靶向药物，对晚期肝细胞癌（HCC）具有高效性。本研究的目的是确定索拉非尼治疗HCC是否比肝动脉灌注化疗（HAIC）更有效。回顾性研究了20例接受索拉非尼治疗的患者（索拉非尼组），起始剂量为800mg/天，以及45例接受HAIC治疗的患者（HAIC组），这些患者均为不可切除的Child-Pugh A级晚期HCC。使用实体瘤疗效评价标准（RECIST）评估治疗效果。结果显示，索拉非尼组的总缓解率显著低于HAIC组（P = 0.03），而两组的疾病控制率和生存率无差异。在索拉非尼组中，19例患者停止治疗，其中12例是由于副作用。在接受索拉非尼治疗的患者亚组中，服用索拉非尼<60天的患者（n = 11）的生存率显著低于治疗≥60天的患者（n = 9）。较短的治疗期（<60天）是生存不良的独立危险因素[风险比（HR），3.34；95%置信区间（CI），1.45 - 7.66，与HAIC相比]，而服用索拉非尼≥60天的患者的生存率与接受HAIC治疗的患者无差异（HR，0.79；95%CI，0.27 - 2.34）。总之，索拉非尼治疗晚期HCC患者的疾病控制率和生存率与HAIC治疗患者相当。然而，由于副作用无法进行长期索拉非尼治疗时，预后较差，这表明索拉非尼治疗患者选择的重要性。
