丙型肝炎病毒根除对接受索拉非尼治疗的丙型肝炎病毒相关晚期肝细胞癌患者临床结局的影响

Impact of Hepatitis C Virus Eradication on the Clinical Outcome of Patients with Hepatitis C Virus-Related Advanced Hepatocellular Carcinoma Treated with Sorafenib.

作者信息

Kawaoka Tomokazu, Aikata Hiroshi, Teraoka Yuji, Inagaki Yuki, Honda Fumi, Hatooka Masahiro, Morio Kei, Morio Reona, Kobayashi Tomoki, Nagaoki Yuko, Nakahara Takashi, Hiramatsu Akira, Tsuge Masataka, Imamura Michio, Kawakami Yoshiiku, Chayama Kazuaki

机构信息

Department of Gastroenterology and Metabolism, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

出版信息

Oncology. 2017;92(6):335-346. doi: 10.1159/000458532. Epub 2017 Mar 1.

DOI:10.1159/000458532

PMID:28245484

Abstract

OBJECTIVE

To evaluate the impact of hepatitis C virus (HCV) eradication on the clinical outcome of patients with HCV-related advanced hepatocellular carcinoma (HCC) treated with sorafenib.

METHODS

A total of 58 HCV-related advanced HCC patients with Child-Pugh grade A disease who were treated with sorafenib were enrolled in this retrospective cohort study. Of these, 27 patients were HCV RNA negative as a result of previous antiviral therapy (sustained viral response [SVR] group), while the remaining 31 were HCV RNA positive (non-SVR group).

RESULTS

The response rate, disease control rate and median time to progression in the SVR group (6, 46.0%, and 3.8 months, respectively) were similar to those in the non-SVR group (3, 51.5%, and 2.7 months, respectively). On the other hand, the median time to treatment failure (TTTF), post-progression survival (PPS), and overall survival (OS) were significantly longer in the SVR group than in the non-SVR group (9.7, 8.5, and 15 months vs. 5.9, 5.2, and 9.3 months; p = 0.023, 0.02, and 0.014, respectively). On multivariate analysis, SVR was identified as a significant and independent determinant of PPS (p = 0.009), TTTF (p = 0.028), and OS (p = 0.01).

CONCLUSION

HCV eradication before sorafenib treatment for HCV-related advanced HCC could prolong PPS and TTTF and improve OS.

摘要

目的

评估丙型肝炎病毒（HCV）根除对接受索拉非尼治疗的HCV相关晚期肝细胞癌（HCC）患者临床结局的影响。

方法

本回顾性队列研究纳入了58例接受索拉非尼治疗的Child-Pugh A级HCV相关晚期HCC患者。其中，27例患者因先前的抗病毒治疗导致HCV RNA阴性（持续病毒学应答[SVR]组），其余31例为HCV RNA阳性（非SVR组）。

结果

SVR组的缓解率、疾病控制率和中位疾病进展时间（分别为6、46.0%和3.8个月）与非SVR组（分别为3、51.5%和2.7个月）相似。另一方面，SVR组的中位治疗失败时间（TTTF）、进展后生存期（PPS）和总生存期（OS）显著长于非SVR组（分别为9.7、8.5和15个月，对比5.9、5.2和9.3个月；p分别为0.023、0.02和0.014）。多因素分析显示，SVR是PPS（p = 0.009）、TTTF（p = 0.028）和OS（p = 0.01）的显著且独立的决定因素。