Gong Quanyou, Qin Zhaoxia, Hou Fangli
Department of Intensive Care Unit, Zhumadian Central Hospital, Zhumadian, Henan 463000, P.R. China.
Department of Urology, Zhumadian Central Hospital, Zhumadian, Henan 463000, P.R. China.
Oncol Lett. 2017 Dec;14(6):7045-7048. doi: 10.3892/ol.2017.7174. Epub 2017 Oct 12.
Small hepatocellular carcinoma is an important leading cause of death amongst cancer patients, our study was designed in order to test the hypothesis that radiofrequency ablation (RFA) combined with a chemotherapeutic drug would improve the outcome for patients. Two groups of patients presenting early small hepatocellular carcinoma were treated with either conventional RFA alone (50 individuals in the control group), or with a combination of RFA and oral sorafenib (40 individuals in an observation group). Individual clinical and laboratory evaluations were done during an average follow-up time of 35 months, and all the data recorded was used to compare results of both treatment approaches. Tumor-free survival, relapse rate and survival rate, RFA interval and number of treatments, overall efficacy and the incidence of complications were analyzed. Serum levels of vascular endothelial growth factor (VEGF), connective tissue growth factor (CTGF), hypoxia inducible factor-1α (HIF-1α) and osteopontin (OPN) were measured and compared. Our results show that the patients in the treatment group had statistically significant prolonged tumor-free survival, decreased relapse and increased survival rates. Also, the patients in the treatment group had significantly more prolonged average intervals of RFA and a lower number of treatments. Furthermore, the overall efficacy in the treatment group was increased, yet the incidence of complications was similar between both groups. Moreover, the serum levels of known tumorigenic factors VEGF, CTGF, HIF-1α and OPN, which were similar between both groups before treatment, improved more markedly after the treatment in the observation group patients. Based on these findings, we propose that sorafenib in combination with percutaneous RFA is safe and efficacious, and a superior treatment for early small hepatocellular carcinoma. Larger studies are needed to corroborate our results.
小肝癌是癌症患者重要的主要死因，我们开展这项研究是为了验证射频消融（RFA）联合化疗药物可改善患者预后这一假设。两组早期小肝癌患者分别接受单纯传统RFA治疗（对照组50例）或RFA联合口服索拉非尼治疗（观察组40例）。在平均35个月的随访期内进行个体临床和实验室评估，并使用所有记录的数据比较两种治疗方法的结果。分析无瘤生存率、复发率和生存率、RFA间隔和治疗次数、总体疗效以及并发症发生率。检测并比较血管内皮生长因子（VEGF）、结缔组织生长因子（CTGF）、缺氧诱导因子-1α（HIF-1α）和骨桥蛋白（OPN）的血清水平。我们的结果显示，治疗组患者的无瘤生存期在统计学上显著延长，复发率降低，生存率提高。此外，治疗组患者的RFA平均间隔明显延长，治疗次数减少。而且，治疗组的总体疗效提高，但两组之间的并发症发生率相似。此外，两组治疗前血清中已知的致瘤因子VEGF、CTGF、HIF-1α和OPN水平相似，而观察组患者治疗后这些指标的改善更为明显。基于这些发现，我们认为索拉非尼联合经皮RFA安全有效，是早期小肝癌的一种更优治疗方法。需要开展更大规模的研究来证实我们的结果。
