Minimally Invasive Interventional Division, Department of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, China.
State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China.
J Hepatol. 2018 Jul;69(1):60-69. doi: 10.1016/j.jhep.2018.02.008. Epub 2018 Feb 20.
BACKGROUND & AIMS: To compare the overall survival (OS) and disease progression free survival (PFS) in patients with advanced hepatocellular carcinoma (Ad-HCC) who are undergoing hepatic arterial infusion (HAI) of oxaliplatin, fluorouracil/leucovorin (FOLFOX) treatment vs. sorafenib.
This retrospective study was approved by the ethical review committee, and informed consent was obtained from all patients before treatment. HAI of FOLFOX (HAIF) was recommended as an alternative treatment option for patients who refused sorafenib. Of the 412 patients with Ad-HCC (376 men and 36 women) between Jan 2012 to Dec 2015, 232 patients were treated with sorafenib; 180 patients were given HAIF therapy. The median age was 51 years (range, 16-82 years). Propensity-score matched estimates were used to reduce bias when evaluating survival. Survival curves were calculated by performing the Kaplan-Meier method and compared by using the log-rank test and Cox regression models.
The median PFS and OS in the HAIF group were significantly longer than those in the sorafenib group (PFS 7.1 vs. 3.3 months [RECIST]/7.4 vs. 3.6 months [mRECIST], respectively; OS 14.5 vs. 7.0 months; p <0.001 for each). In the propensity-score matched cohorts (147 pairs), both PFS and OS in the HAIF group were longer than those in the sorafenib group (p <0.001). At multivariate analysis, HAIF treatment was an independent factor for PFS (hazard ratio [HR] 0.389 [RECIST]/0.402 [mRECIST]; p <0.001 for each) and OS (HR 0.129; p <0.001).
HAIF therapy may improve survival compared to sorafenib in patients with Ad-HCC. A prospective randomized trial is ongoing to confirm this finding.
We compared the hepatic arterial infusion of FOLFOX (a combination chemotherapy) with sorafenib (a tyrosine kinase inhibitor) in patients with advanced hepatocellular carcinoma, retrospectively. It was found that hepatic arterial infusion of FOLFOX therapy may improve both progression free and overall survival in patients with advanced hepatocellular carcinoma.
比较接受奥沙利铂氟尿嘧啶/亚叶酸（FOLFOX）肝动脉灌注（HAI）治疗与索拉非尼治疗的晚期肝细胞癌（Ad-HCC）患者的总生存期（OS）和无疾病进展生存期（PFS）。
本回顾性研究获得了伦理审查委员会的批准，并在治疗前获得了所有患者的知情同意。对于拒绝索拉非尼的患者，建议将 FOLFOX 的 HAI（HAIF）作为替代治疗选择。在 2012 年 1 月至 2015 年 12 月期间，共有 412 例 Ad-HCC 患者（376 名男性和 36 名女性），其中 232 例接受索拉非尼治疗，180 例接受 HAIF 治疗。中位年龄为 51 岁（范围 16-82 岁）。使用倾向评分匹配估计来减少评估生存时的偏差。通过Kaplan-Meier 方法计算生存曲线，并通过对数秩检验和 Cox 回归模型进行比较。
HAIF 组的中位 PFS 和 OS 明显长于索拉非尼组（RECIST 标准下的 PFS 为 7.1 个月 vs. 3.3 个月，mRECIST 标准下的 PFS 为 7.4 个月 vs. 3.6 个月；OS 为 14.5 个月 vs. 7.0 个月；每个标准均 p<0.001）。在倾向评分匹配的队列中（147 对），HAIF 组的 PFS 和 OS 均长于索拉非尼组（p<0.001）。多变量分析显示，HAIF 治疗是 PFS（风险比 [HR] 0.389 [RECIST] / 0.402 [mRECIST]；每个标准均 p<0.001）和 OS（HR 0.129；p<0.001）的独立因素。
与索拉非尼相比，HAIF 治疗可能改善 Ad-HCC 患者的生存。一项正在进行的前瞻性随机试验正在确认这一发现。
我们回顾性比较了晚期肝细胞癌患者的 FOLFOX 肝动脉灌注（一种联合化疗）与索拉非尼（一种酪氨酸激酶抑制剂）的疗效。结果发现，FOLFOX 的 HAI 治疗可能改善晚期肝细胞癌患者的无进展生存期和总生存期。
