肝细胞癌的动脉血供与索拉非尼治疗的疗效相关。

Arterial blood supply of hepatocellular carcinoma is associated with efficacy of sorafenib therapy.

机构信息

1 Department of Hepatobiliary Surgery, Jingmen First People's Hospital, Jingmen 448000, China ; 2 Department of Hepatic Surgery I, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China.

出版信息

Ann Transl Med. 2015 Nov;3(19):285. doi: 10.3978/j.issn.2305-5839.2015.10.24.

DOI:10.3978/j.issn.2305-5839.2015.10.24

PMID:26697445

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4671861/

Abstract

BACKGROUND

To explore the efficacy of sorafenib in treating hepatocellular carcinoma (HCC) and its relationship with the computed tomography (CT) and magnetic resonance imaging (MRI) features of HCC, analyze the prognostic factors of HCC patients treated with sorafenib, and investigate the relationship between imaging findings and outcomes.

METHODS

A total of 38 HCC patients who were treated with sorafenib from April 2009 to December 2010 were included in this study. HCCs were classified as good arterial supply and poor arterial supply according to the intensity enhancement on CT scan or MRI. Clinical data were collected and the survival time was calculated by Kaplan-Meier method.

RESULTS

Among these 38 patients [35 (92.1%) were males] treated with sorafenib, the median age was (53.3±11.1) years. Tumors in 17 patients had good arterial supply while those in the remained 21 patients had poor arterial supply. The median survival time (MST) was 10.7 months (95% CI, 8.7-12.7) and the 1-year overall survival (OS) was 41.0%. The MST and 1-year OS in patients with tumors with good arterial supply were 12 months (range, 4-20 months) and 52.9%, respectively, compared with those of 7 months (range, 1-16 months) and 23.8% in patients with tumors with poor arterial supply (P=0.002). Patients with BCLC stage B tumors had longer MST and higher OS than those with BCLC stage C tumors, although the differences were not statistically significant. Multivariate analysis showed that arterial supply of tumors remained statistically predictive for OS (HR =0.22; 95% CI, 0.07-0.67; P=0.008).

CONCLUSIONS

Arterial blood supply is an independent predictor for survival in HCC patients treated with sorafenib, and patients with tumors with good arterial supply benefit more than those with tumors with poor arterial supply.

摘要

背景

探讨索拉非尼治疗肝细胞癌（HCC）的疗效及其与 HCC 的 CT 和 MRI 特征的关系，分析索拉非尼治疗 HCC 患者的预后因素，并探讨影像学表现与结局的关系。

方法

本研究纳入了 2009 年 4 月至 2010 年 12 月期间接受索拉非尼治疗的 38 例 HCC 患者。根据 CT 扫描或 MRI 上的强化程度，将 HCC 分为动脉血供良好和动脉血供不良。收集临床资料，采用 Kaplan-Meier 法计算生存时间。

结果

38 例接受索拉非尼治疗的患者中[35 例（92.1%）为男性]，中位年龄为（53.3±11.1）岁。17 例患者肿瘤动脉血供良好，21 例患者肿瘤动脉血供不良。中位生存时间（MST）为 10.7 个月（95%CI，8.7-12.7），1 年总生存率（OS）为 41.0%。动脉血供良好肿瘤患者的 MST 和 1 年 OS 分别为 12 个月（范围，4-20 个月）和 52.9%，而动脉血供不良肿瘤患者的 MST 和 1 年 OS 分别为 7 个月（范围，1-16 个月）和 23.8%（P=0.002）。BCLC 分期 B 期肿瘤患者的 MST 和 OS 均长于 BCLC 分期 C 期肿瘤患者，但差异无统计学意义。多因素分析显示，肿瘤的动脉血供仍是 OS 的独立预测因素（HR=0.22；95%CI，0.07-0.67；P=0.008）。