Zhao Yang, Lai JiaYing, Liang RunBin, He MinKe, Shi Ming
Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
HuiDong Senior Middle School, Huidong, Huizhou, China.
J Interv Med. 2019 Jul 31;2(2):78-83. doi: 10.1016/j.jimed.2019.07.005. eCollection 2019 May.
To compare the efficacy of sorafenib plus hepatic arterial infusion chemotherapy (HAIC) with oxaliplatin to that of sorafenib alone in patients with advanced hepatocellular carcinoma (HCC).
This was a retrospective, single-center trial. Between April 3, 2017 and July 2, 2018, 104 patients with Child-Pugh A and advanced HCC received either 400 mg of sorafenib orally twice daily plus HAIC with oxaliplatin (oxaliplatin 85 mg/m, every 3 weeks via repetitive catheterization) (n = 46, soraOXA group) or 400 mg of only sorafenib orally twice daily (n = 58, sorafenib group). Overall survival, progression-free survival, objective response rate, and treatment-related adverse events were compared.
The median overall survival was 9.37 months (95% CI, 7.05-11.68) in the soraOXA group versus 4.8 months (95% CI, 2.98-6.62) in the sorafenib group (HR 0.46 [95% CI, 0.29-0.72]; < 0.001). The soraOXA group also showed a higher objective response rate (16 [34.8%] vs 1 [1.7%]; < 0.001) and a longer progression-free survival rate (5.5 months [95% CI, 2.32-8.68] vs 2.4 months [95% CI, 1.65-3.15], HR 0.54 [95% CI, 0.36-0.81], = 0.003) than the sorafenib group. There was no significant difference in the overall incidence of any grade adverse events, grade 3/4 adverse events, serious adverse events, or incidence of treatment termination due to adverse events between the two groups.
Compared with sorafenib alone, sorafenib plus HAIC with oxaliplatin showed favorable treatment outcomes in patients with advanced HCC. The merits of this approach need to be established with a prospective trial.
比较索拉非尼联合肝动脉灌注化疗(HAIC)及奥沙利铂与单独使用索拉非尼治疗晚期肝细胞癌(HCC)患者的疗效。
这是一项回顾性单中心试验。2017年4月3日至2018年7月2日期间,104例Child-Pugh A级晚期HCC患者接受了以下治疗:每日两次口服400mg索拉非尼联合HAIC及奥沙利铂(奥沙利铂85mg/m²,每3周经重复导管插入术给药)(n = 46,索拉非尼联合奥沙利铂组)或仅每日两次口服400mg索拉非尼(n = 58,索拉非尼组)。比较总生存期、无进展生存期、客观缓解率及治疗相关不良事件。
索拉非尼联合奥沙利铂组的中位总生存期为9.37个月(95%CI,7.05 - 11.68),而索拉非尼组为4.8个月(95%CI,2.98 - 6.62)(风险比0.46 [95%CI,0.29 - 0.72];P < 0.001)。索拉非尼联合奥沙利铂组的客观缓解率也更高(16例[34.8%]对1例[1.7%];P < 0.001),无进展生存期更长(5.5个月[95%CI,2.32 - 8.68]对2.4个月[95%CI,1.65 - 3.15],风险比0.54 [95%CI,0.36 - 0.81],P = 0.003)。两组在任何级别不良事件、3/4级不良事件、严重不良事件的总发生率或因不良事件导致的治疗终止发生率方面均无显著差异。
与单独使用索拉非尼相比,索拉非尼联合HAIC及奥沙利铂在晚期HCC患者中显示出良好的治疗效果。这种方法的优点需要通过前瞻性试验来确定。