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经动脉化疗栓塞术(TACE)联合索拉非尼与单纯TACE治疗BCLC C期肝细胞癌患者的回顾性研究

Transarterial Chemoembolization (TACE) Combined With Sorafenib versus TACE in Patients With BCLC Stage C Hepatocellular Carcinoma - A Retrospective Study.

作者信息

Patidar Yashwant, Chandel Karamvir, Condati Naveen K, Srinivasan Shyam V, Mukund Amar, Sarin Shiv K

机构信息

Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India.

Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.

出版信息

J Clin Exp Hepatol. 2022 May-Jun;12(3):745-754. doi: 10.1016/j.jceh.2021.12.009. Epub 2021 Dec 21.

Abstract

OBJECTIVE

Advanced-stage hepatocellular carcinoma is a heterogeneous group with limited treatment options. TACE has been advocated recently by various study groups. The purpose of this study was to evaluate if TACE in combination with sorafenib, as well as TACE alone, was safe and efficacious in treating BCLC stage C HCC.

METHODS

A retrospective evaluation of the clinical data of 78 patients with BCLC stage C HCC who received either TACE-sorafenib (TS) combination therapy or TACE monotherapy as their first treatment was done. The two groups were compared in terms of radiological tumor response 1 month after the intervention. The two groups were also compared in terms of time to progression (TTP), overall survival (OS), and adverse events.

RESULTS

The disease control rate (44.9% and 25.8%, respectively,  = 0.09) was higher in the TS combination group than in the TACE monotherapy group after 1 month of treatment. The TS combination group had significantly superior TTP and OS than the TACE group (TTP was 4.6 and 3.1 months, respectively,  = 0.001), and OS was 10.1 and 7.8 months, respectively, < 0.001). The TACE-S group had a greater cumulative survival time at 6 months, 9 months, and 1 year than the TACE group (97.9%, 51.1%, 25.7% vs. 90.4%, 51.6%, and 0%, respectively).

CONCLUSION

TS combination therapy in advanced-stage (BCLC-C) HCC significantly improved disease control rate, TTP, and OS compared with TACE alone, without any significant increase in adverse reactions.

摘要

目的

晚期肝细胞癌是一个异质性群体,治疗选择有限。近期各研究小组都主张采用经动脉化疗栓塞术(TACE)。本研究的目的是评估TACE联合索拉非尼以及单纯TACE治疗巴塞罗那临床肝癌(BCLC)C期肝癌是否安全有效。

方法

对78例接受TACE-索拉非尼(TS)联合治疗或TACE单药治疗作为首次治疗的BCLC C期肝癌患者的临床资料进行回顾性评估。比较两组干预后1个月的放射学肿瘤反应。还比较了两组的疾病进展时间(TTP)、总生存期(OS)和不良事件。

结果

治疗1个月后,TS联合治疗组的疾病控制率(分别为44.9%和25.8%,P = 0.09)高于TACE单药治疗组。TS联合治疗组的TTP和OS显著优于TACE组(TTP分别为4.6个月和3.1个月,P = 0.001),OS分别为10.1个月和7.8个月,P < 0.001)。在6个月、9个月和1年时,TACE-S组的累积生存时间长于TACE组(分别为97.9%、51.1%、25.7%对90.4%、51.6%和0%)。

结论

与单纯TACE相比,晚期(BCLC-C)肝癌的TS联合治疗显著提高了疾病控制率、TTP和OS,且不良反应无显著增加。

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