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基于不可治疗性经动脉化疗栓塞术(unTACEable)进展评估经动脉化疗栓塞术(TACE)联合索拉非尼治疗肝细胞癌的益处

Evaluation of the Benefits of TACE Combined with Sorafenib for Hepatocellular Carcinoma Based on Untreatable TACE (unTACEable) Progression.

作者信息

Zou Xinhua, Fan Wenzhe, Xue Miao, Li Jiaping

机构信息

Department of Interventional Oncology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou City, Guangdong Province, 510080, People's Republic of China.

出版信息

Cancer Manag Res. 2021 May 18;13:4013-4029. doi: 10.2147/CMAR.S304591. eCollection 2021.

Abstract

PURPOSE

Outcomes after the treatment for unresectable or advanced-stage hepatocellular carcinoma (HCC) are unsatisfied. We evaluated the therapeutic benefits of a combination therapy strategy for these patients through transarterial chemoembolization (TACE) plus sorafenib.

PATIENTS AND METHODS

In total, 85 patients with HCC classified as intermediate and advanced stage from June 2012 to November 2017 were retrospectively investigated. We divided patients into the monotherapy (n=43; TACE alone) and combined therapy (n=42; TACE plus sorafenib) groups.

RESULTS

Compared with the TACE alone group, the TACE plus sorafenib experienced significantly prolonged progression-free survival (PFS) (mean 21 months vs 12 months; P = 0.0005) and overall survival (OS) (mean 32 months vs 21 months; P = 0.0157). The disease control rate (DCR) of TACE plus sorafenib group was 80.95%, which was significantly increased than the TACE alone group (55.81%) (P<0.05), as well as objective response rate (ORR) (23.81% vs 16.28%). Besides, the rates of liver-related AEs and liver failure in the TACE plus sorafenib group were not increased in contrast to TACE alone group, and there were no new safety concerns. To sum up, the superiority of combination therapy with significantly prolonging progression-free and overall survival was observed, meanwhile finding a significant increase in tumor response rate and manageable safety in the combined therapy in contrast to the monotherapy group.

CONCLUSION

Based on unTACEble progression, the superiority of the combination therapy is that TACE plus sorafenib has been bringing about significantly better outcomes compared with TACE alone for HCC patients.

摘要

目的

不可切除或晚期肝细胞癌(HCC)的治疗效果不尽人意。我们通过经动脉化疗栓塞术(TACE)联合索拉非尼评估了该联合治疗策略对这些患者的治疗益处。

患者与方法

回顾性研究了2012年6月至2017年11月期间共85例被归类为中晚期的HCC患者。我们将患者分为单药治疗组(n = 43;单纯TACE)和联合治疗组(n = 42;TACE联合索拉非尼)。

结果

与单纯TACE组相比,TACE联合索拉非尼组的无进展生存期(PFS)显著延长(平均21个月对12个月;P = 0.0005),总生存期(OS)也显著延长(平均32个月对21个月;P = 0.0157)。TACE联合索拉非尼组的疾病控制率(DCR)为80.95%,显著高于单纯TACE组(55.81%)(P<0.05),客观缓解率(ORR)也更高(23.81%对16.28%)。此外,与单纯TACE组相比,TACE联合索拉非尼组的肝脏相关不良事件和肝衰竭发生率并未增加,也没有新的安全问题。综上所述,观察到联合治疗具有显著延长无进展生存期和总生存期的优势,同时与单药治疗组相比,联合治疗的肿瘤反应率显著提高且安全性可控。

结论

基于无法进行TACE的进展情况,联合治疗的优势在于,对于HCC患者,TACE联合索拉非尼比单纯TACE带来的治疗效果显著更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecd4/8142557/eebf0c639628/CMAR-13-4013-g0001.jpg

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