Abdel-Rahman Omar, Abdelwahab Manal, Shaker Mohammed, Abdelwahab Sherif, Elbassiony Mohammed, Ellithy Mahmoud
Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Abbaseya Square, Cairo, Egypt.
Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Abbaseya Square, Cairo, Egypt.
J Egypt Natl Canc Inst. 2014 Mar;26(1):9-13. doi: 10.1016/j.jnci.2013.08.003. Epub 2013 Sep 16.
According to the results of a number of phase 3 randomized studies, sorafenib is the only approved systemic therapy for advanced HCC; however the issue of high economic cost remains challenging; thus we have conducted this retrospective analysis of our HCC patients treated with sorafenib.
HCC patients treated at Ain Shams University Hospitals, in the period between 2010 and 2012 were reviewed. Eligible patients were those who had received sorafenib for advanced HCC not eligible for or progressed after surgery or locoregional therapy. We investigated the impact of baseline clinicopathological factors (age, gender, child status, performance score, BCLC tumor stage, cause of chronic liver disease, median baseline alpha fetoprotein level and previous treatment received for HCC) on overall survival (OS) in an adjusted Cox regression model.
41 patients were included in the analysis fulfilling the inclusion criteria. At a median follow up period of 13 months, the median PFS for the whole group was 4 months; the median OS for the whole group is 6.25 months. Multivariate analysis identified three baseline characteristics that were prognostic indicators for overall survival: ECOG performance status (median OS for ECOG 1=7.01 months and for ECOG 2=3.03 months), Child-Pugh status (median OS for child A=12.04 months and for child B=5.23 months), and median baseline levels of alpha-fetoprotein.
In limited resource countries like Egypt, we suggest that the use of sorafenib for the treatment of advanced HCC cases should be restricted to a highly selected subgroup of patients with good performance and child A.
根据多项3期随机研究的结果，索拉非尼是唯一被批准用于晚期肝癌的全身治疗药物；然而，高昂的经济成本问题仍然具有挑战性；因此，我们对接受索拉非尼治疗的肝癌患者进行了这项回顾性分析。
回顾了2010年至2012年期间在艾因夏姆斯大学医院接受治疗的肝癌患者。符合条件的患者是那些因晚期肝癌接受索拉非尼治疗且不适合手术或局部区域治疗或在手术后或局部区域治疗后病情进展的患者。我们在调整后的Cox回归模型中研究了基线临床病理因素（年龄、性别、Child分级、体能状态评分、BCLC肿瘤分期、慢性肝病病因、基线甲胎蛋白水平中位数以及之前接受的肝癌治疗）对总生存期（OS）的影响。
41例患者纳入分析，符合纳入标准。中位随访期为13个月，全组的中位无进展生存期为4个月；全组的中位总生存期为6.25个月。多因素分析确定了三个作为总生存期预后指标的基线特征：ECOG体能状态（ECOG 1的中位总生存期=7.01个月，ECOG 2的中位总生存期=3.03个月）、Child-Pugh分级状态（Child A的中位总生存期=12.04个月，Child B的中位总生存期=5.23个月）以及甲胎蛋白基线水平中位数。
在埃及这样资源有限的国家，我们建议索拉非尼用于治疗晚期肝癌病例应仅限于经过高度筛选的、体能状态良好且为Child A级的亚组患者。
