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评估仑伐替尼治疗合并肝硬化的不可切除肝细胞癌。

Assessment of lenvatinib treatment for unresectable hepatocellular carcinoma with liver cirrhosis.

机构信息

Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.

Department of Internal Medicine, Division of Gastroenterology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.

出版信息

HPB (Oxford). 2020 Oct;22(10):1450-1456. doi: 10.1016/j.hpb.2020.03.002. Epub 2020 Mar 29.

Abstract

BACKGROUND

The present study aimed to assess the clinical features of patients who received lenvatinib treatment for unresectable hepatocellular carcinoma (HCC).

METHODS

The clinical characteristics, adverse events, and radiological responses were evaluated for 51 consecutive patients.

RESULTS

Of the study subjects, 37 patients had Child-Pugh class A (CPA) liver function, and 14 patients had Child-Pugh class B (CPB) liver function. The overall response rates in the CPA and CPB groups were 42.9% and 25.0%, respectively, and disease control rates were 82.9% and 83.3%, respectively, without significant difference (p = 0.2621 and 0.9697). There was no significant difference between CPA and CPB groups regarding the incidence of adverse events, except for hepatic coma. No significant difference was observed in the relative dose intensity between the CPA and CPB groups, for the first month, 1-2 months, or 2-3 months (p = 0.2368, 0.9368, and 0.9293).

CONCLUSION

The comparable outcomes between the CPA and CPB groups suggest the acceptability of lenvatinib treatment in patients with impaired liver function, at least in the acute phase. With careful follow-up, the dose can be relatively intensified, even in patients with impaired liver function and this may contribute to offering comparable treatment.

摘要

背景

本研究旨在评估接受仑伐替尼治疗不可切除肝细胞癌(HCC)患者的临床特征。

方法

对 51 例连续患者的临床特征、不良反应和影像学反应进行了评估。

结果

在研究对象中,37 例患者肝功能为 Child-Pugh 分级 A(CPA),14 例患者肝功能为 Child-Pugh 分级 B(CPB)。CPA 和 CPB 组的总体缓解率分别为 42.9%和 25.0%,疾病控制率分别为 82.9%和 83.3%,差异无统计学意义(p=0.2621 和 0.9697)。除肝性脑病外,CPA 和 CPB 组之间不良反应的发生率无显著差异。CPA 和 CPB 组在第一个月、1-2 个月和 2-3 个月的相对剂量强度无显著差异(p=0.2368、0.9368 和 0.9293)。

结论

CPA 和 CPB 组之间的结果相当,表明仑伐替尼治疗肝功能受损患者是可以接受的,至少在急性期是如此。通过密切随访,可以相对增加剂量,即使是肝功能受损的患者,这可能有助于提供相当的治疗。

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