Koch Christine, Göller Markus, Schott Eckart, Waidmann Oliver, Op den Winkel Mark, Paprottka Philipp, Zangos Stephan, Vogl Thomas, Bechstein Wolf Otto, Zeuzem Stefan, Kolligs Frank T, Trojan Jörg
Department of Medicine 1, University Hospital Frankfurt, Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
University Cancer Centre, University Hospital Frankfurt, Goethe-University, 60590 Frankfurt, Germany.
Cancers (Basel). 2021 Apr 28;13(9):2121. doi: 10.3390/cancers13092121.
Systemic treatment with sorafenib has been the standard of care (SOC) in patients with advanced Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC) for more than a decade. TACE has been reported to allow better local tumor control in selected patients with BCLC stage C HCC.
A retrospective analysis of patients with BCLC stage C HCC that were treated with sorafenib and TACE was conducted; they were compared to BCLC stage C patients treated either with TACE or sorafenib in the same period of time outside a clinical trial.
A total of 201 patients with BCLC stage C were identified, who were treated with either sorafenib and TACE (group A; = 54), sorafenib (group B; = 82) or TACE (group C; = 65). No significant difference in baseline characteristics was observed. Time to progression was 7.0 months (95% CI: 4.3-9.7), 4.1 months (95% CI: 3.6-4.7) and 5.0 months (95% CI: 2.9-7.1) in groups A, B and C, respectively, and overall survival was 16.5 months (95% CI: 15.0-18.1), 8.4 months (95% CI: 6.0-10.8) and 10.5 months (95% CI: 7.5-13.6), respectively (group A vs. group B: < 0.001; group A vs. group C: = 0.0023). Adverse events of grade 3/4 occurred in 34% of patients in group A.
Although sorafenib is a SOC in patients with BCLC stage C HCC, TACE is frequently used as an additional locoregional treatment in selected patients. This combined approach resulted in a significant overall survival benefit in selected patients, although randomized trials have not yet proven this benefit.
十多年来，索拉非尼全身治疗一直是晚期巴塞罗那临床肝癌（BCLC）C期肝细胞癌（HCC）患者的标准治疗方案（SOC）。据报道，经动脉化疗栓塞术（TACE）可使部分BCLC C期HCC患者获得更好的局部肿瘤控制。
对接受索拉非尼和TACE治疗的BCLC C期HCC患者进行回顾性分析；将他们与同期在临床试验之外接受TACE或索拉非尼治疗的BCLC C期患者进行比较。
共纳入201例BCLC C期患者，分别接受索拉非尼联合TACE治疗（A组；n = 54）、索拉非尼治疗（B组；n = 82）或TACE治疗（C组；n = 65）。各基线特征未见显著差异。A、B、C组的疾病进展时间分别为7.0个月（95%CI：4.3 - 9.7）、4.1个月（95%CI：3.6 - 4.7）和5.0个月（95%CI：2.9 - 7.1），总生存期分别为16.5个月（95%CI：15.0 - 18.1）、8.4个月（95%CI：6.0 - 10.8）和10.5个月（95%CI：7.5 - 13.6）（A组 vs. B组：P < 0.001；A组 vs. C组：P = 0.0023）。A组34%的患者发生3/4级不良事件。
尽管索拉非尼是BCLC C期HCC患者的SOC，但TACE常被用作部分患者的额外局部区域治疗。这种联合治疗方法使部分患者的总生存期显著获益，尽管随机试验尚未证实这一获益。
