Kodama Kenichiro, Kawaoka Tomokazu, Aikata Hiroshi, Uchikawa Shinsuke, Nishida Yuno, Inagaki Yuki, Hatooka Masahiro, Morio Kei, Nakahara Takashi, Murakami Eisuke, Tsuge Masataka, Hiramatsu Akira, Imamura Michio, Kawakami Yoshiiku, Masaki Keiichi, Honda Yoji, Mori Nami, Takaki Shintaro, Tsuji Keiji, Kohno Hirotaka, Kohno Hiroshi, Moriya Takashi, Nonaka Michihiro, Hyogo Hideyuki, Aisaka Yasuyuki, Kimura Tomoki, Nagata Yasushi, Chayama Kazuaki
Department of Medicine and Molecular Science, Division of Frontier Medical Science, Hiroshima University, Hiroshima, Japan.
Hiroshima City Asa Hospital, Hiroshima, Japan.
Oncology. 2018;94(4):215-222. doi: 10.1159/000486483. Epub 2018 Feb 9.
To compare the outcome of hepatic arterial infusion chemotherapy combined with radiotherapy (HAIC + RT) versus sorafenib monotherapy in patients with advanced hepatocellular carcinoma (HCC) and major portal vein tumor thrombosis (PVTT).
This retrospective study included 108 HCC patients with PVTT of the main trunk or first branch and Child-Pugh ≤7. Sixty-eight received HAIC + RT and 40 received sorafenib. Patients were then assigned to the HAIC + RT group (n = 36) and the sorafenib group (n = 36) through case-control matching. The decision to treat with HAIC + RT or sorafenib was left to the attending physician.
The median overall, progression-free, and postprogression survival were significantly longer in the HAIC + RT group than in the sorafenib group (9.9 vs. 5.3, p = 0.002; 3.9 vs. 2.1, p = 0.048; and 3.7 vs. 1.9 months, p = 0.02, respectively). Multivariate analysis identified HAIC + RT (hazard ratio = 2.02; 95% confidence interval, 1.14-3.57; p = 0.01) as a significant and independent determinant of overall survival.
In patients with advanced HCC and major PVTT, survival was significantly longer in those treated with HAIC + RT than with sorafenib.
比较肝动脉灌注化疗联合放疗（HAIC + RT）与索拉非尼单药治疗晚期肝细胞癌（HCC）合并主要门静脉肿瘤血栓形成（PVTT）患者的疗效。
这项回顾性研究纳入了108例主干或一级分支PVTT且Child-Pugh评分≤7的HCC患者。68例接受HAIC + RT，40例接受索拉非尼治疗。然后通过病例对照匹配将患者分为HAIC + RT组（n = 36）和索拉非尼组（n = 36）。采用HAIC + RT或索拉非尼治疗的决策由主治医师决定。
HAIC + RT组的中位总生存期、无进展生存期和进展后生存期均显著长于索拉非尼组（分别为9.9个月对5.3个月，p = 0.002；3.9个月对2.1个月，p = 0.048；3.7个月对1.9个月，p = 0.02）。多因素分析确定HAIC + RT（风险比 = 2.02；95%置信区间，1.14 - 3.57；p = 0.01）是总生存期的显著且独立决定因素。
在晚期HCC合并主要PVTT患者中，接受HAIC + RT治疗的患者生存期显著长于接受索拉非尼治疗的患者。
