Shiozawa Kazue, Watanabe Manabu, Ikehara Takashi, Kogame Michio, Matsui Teppei, Okano Naoki, Kikuchi Yoshinori, Nagai Hidenari, Ishii Koji, Makino Hiroyuki, Igarashi Yoshinori, Sumino Yasukiyo
Hepatogastroenterology. 2014 Jun;61(132):885-91.
BACKGROUND/AIMS: This prospective non-randomized controlled trial aimed to compare the efficacy of sorafenib vs hepatic arterial infusion chemotherapy (HAIC) for advanced hepatocellular carcinoma.
Forty-seven patients treated with sorafenib (sorafenib group) and 77 patients treated with HAIC (HAIC group) were investigated retrospectively using propensity score matching (PSM) to minimize selection bias. The cumulative survival rate was investigated before and after PSM in each of the sorafenib and HAIC groups. The cumulative survival rate was compared between the sorafenib and HAIC groups, and among the TNM stage by the Liver Cancer Study Group of Japan (LCSGJ TNM stage).
No significant difference was noted in overall survival (OS) between the sorafenib and HAIC groups regardless of before or after PSM. On comparison of the cumulative survival rate between the groups by the same LCSGJ TNM stage, significant prolongation of OS was noted in stage IVB only in the sorafenib group (p = 0.032) after PSM.
It may be better to actively introduce sorafenib for stage IVB, i.e., patients with extrahepatic metastasis.
背景/目的:这项前瞻性非随机对照试验旨在比较索拉非尼与肝动脉灌注化疗(HAIC)治疗晚期肝细胞癌的疗效。
对47例接受索拉非尼治疗的患者(索拉非尼组)和77例接受HAIC治疗的患者(HAIC组)进行回顾性研究,采用倾向评分匹配(PSM)以尽量减少选择偏倚。对索拉非尼组和HAIC组在PSM前后的累积生存率进行研究。比较索拉非尼组和HAIC组之间以及日本肝癌研究组(LCSGJ TNM分期)的TNM分期之间的累积生存率。
无论PSM前后,索拉非尼组和HAIC组的总生存期(OS)均无显著差异。在按相同LCSGJ TNM分期比较两组的累积生存率时,PSM后仅索拉非尼组的IVB期OS有显著延长(p = 0.032)。
对于IVB期,即有肝外转移的患者,积极引入索拉非尼可能更好。