Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China.
Xuzhou Central Hospital, Xuzhou, China.
J Surg Oncol. 2022 Dec;126(7):1205-1214. doi: 10.1002/jso.27023. Epub 2022 Jul 20.
About 55% of hepatocellular carcinoma (HCC) cases in China are advanced HCC at the initial diagnosis. We aimed to evaluate the efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) for HCC with portal vein tumor thrombosis (PVTT) compared to transcatheter arterial chemoembolization (TACE) after propensity score matching (PSM).
A propensity score-matched cohort study was performed in patients with advanced HCC with PVTT who underwent either HAIC using oxaliplatin plus raltitrexed or TACE at three institutions between January 2016 and January 2021. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and adverse events were compared between the groups.
After PSM, 44 pairs of patients were assessed. The HAIC group had longer OS (11.2 [95% confidence interval [CI]: 9.9-12.5] vs. 9.0 [95% CI: 5.3-12.7] months; p = 0.010), better PFS (5.6 [95% CI: 3.7-7.9] vs. 2.0 [95% CI: 1.3-2.7] months; p = 0.006), and a higher ORR (Response Evaluation Criteria in Solid Tumors [version 1.1]: 56.8% vs. 18.2%; p < 0.001) than the TACE group. In multivariate analysis, HAIC was identified as an independent favorable prognostic factor for survival.
Compared to TACE, HAIC significantly increased the ORR of HCC with portal invasion and prolonged survival without causing a significant increase in severe adverse events.
在中国，约有 55%的肝细胞癌（HCC）病例在初始诊断时已处于晚期 HCC 阶段。我们旨在通过倾向评分匹配（PSM），评估奥沙利铂联合雷替曲塞肝动脉灌注化疗（HAIC）与经导管动脉化疗栓塞（TACE）治疗伴有门静脉癌栓（PVTT）的 HCC 的疗效和安全性。
对 2016 年 1 月至 2021 年 1 月期间在三个机构接受奥沙利铂联合雷替曲塞 HAIC 或 TACE 治疗的伴有 PVTT 的晚期 HCC 患者进行了倾向评分匹配的队列研究。比较两组患者的总生存期（OS）、无进展生存期（PFS）、客观缓解率（ORR）和不良事件。
PSM 后，评估了 44 对患者。HAIC 组的 OS 更长（11.2[95%置信区间（CI）：9.9-12.5] vs. 9.0[95% CI：5.3-12.7]个月；p=0.010），PFS 更好（5.6[95% CI：3.7-7.9] vs. 2.0[95% CI：1.3-2.7]个月；p=0.006），ORR 更高（实体瘤反应评价标准（版本 1.1）：56.8% vs. 18.2%；p<0.001）。多变量分析表明，HAIC 是生存的独立有利预后因素。
与 TACE 相比，HAIC 显著提高了伴有门静脉侵犯的 HCC 的 ORR，并延长了生存时间，而不会导致严重不良事件显著增加。
