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索拉非尼治疗老年晚期肝细胞癌患者的疗效和安全性。

Efficacy and safety of sorafenib in elderly patients with advanced hepatocellular carcinoma.

机构信息

Instituto do Cancer do Estado de Sao Paulo (ICESP), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.

出版信息

Clinics (Sao Paulo). 2021 Jan 22;76:e2498. doi: 10.6061/clinics/2021/e2498. eCollection 2021.

Abstract

OBJECTIVES

To evaluate the efficacy and safety of sorafenib in elderly patients with advanced hepatocellular carcinoma (HCC).

METHODS

We analyzed data from a cohort of patients with advanced HCC treated using systemic treatment according to the local institutional protocol. Patients were divided into two groups, Group A, individuals <70 years of age, and Group B, individuals 70 years of age or older at the time of treatment initiation. Efficacy, measured based on overall survival (OS) and time to treatment failure (TTF), and toxicity were compared between groups.

RESULTS

A total of 238 patients with advanced HCC who received sorafenib between 2007 and 2018 were evaluated. The median age for Group A was 59.1 years and that for Group B 73.6 years. The major prognostic characteristics were balanced between the groups. There were no significant differences in OS between Group A (8.0 months, 95%CI 6.34-9.3) and Group B (9.0 months, 95%CI 5.38-12.62), p=0.433, or in TTF between Group A (3.0 months, 95%CI 2.39-3.60) and Group B (3.0 months, 95%CI 1.68-4.32), p=0.936. There were no significant differences between Groups A and B with respect to the incidence of adverse events or treatment discontinuation because of toxicity.

CONCLUSION

Efficacy and safety of sorafenib did not differ significantly between younger and older patients with HCC. Our data suggest that age alone should not restrict clinical decision-making for patients with advanced HCC.

摘要

目的

评估索拉非尼治疗老年晚期肝细胞癌(HCC)患者的疗效和安全性。

方法

我们分析了根据当地机构方案接受系统治疗的晚期 HCC 患者队列的数据。患者分为两组,A 组为年龄<70 岁的个体,B 组为治疗开始时年龄为 70 岁或以上的个体。比较两组之间的疗效(基于总生存(OS)和治疗失败时间(TTF))和毒性。

结果

共评估了 2007 年至 2018 年期间接受索拉非尼治疗的 238 例晚期 HCC 患者。A 组的中位年龄为 59.1 岁,B 组为 73.6 岁。主要预后特征在两组之间平衡。A 组(8.0 个月,95%CI 6.34-9.3)和 B 组(9.0 个月,95%CI 5.38-12.62)的 OS 之间无显著差异,p=0.433,或 TTF 之间无显著差异A 组(3.0 个月,95%CI 2.39-3.60)和 B 组(3.0 个月,95%CI 1.68-4.32),p=0.936。A 组和 B 组之间在不良事件的发生率或因毒性而停止治疗方面无显著差异。

结论

索拉非尼在年轻和老年 HCC 患者中的疗效和安全性无显著差异。我们的数据表明,年龄本身不应限制晚期 HCC 患者的临床决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73ee/7811833/b1317f49e500/cln-76-e2498-g001.jpg

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