Zhang Xia, Cai Lirong, Fang Jian, Chen Fengsui, Pan Fan, Zhang Kun, Huang Qian, Huang Yuju, Li Dongliang, Lv Lizhi, Chen Man, Yan Ruiying, Lai Yanhua, Peng Yonghai, Wu Zhixian
Department of Hepatobiliary Disease, the 900th Hospital of Joint Logistics Support Force, Fujian Medical University, Fuzhou, China.
Department of Hepatobiliary Disease, The Third People's Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China.
Front Oncol. 2023 Jan 13;12:1101351. doi: 10.3389/fonc.2022.1101351. eCollection 2022.
To explore the benefit and safety of transarterial chemoembolization (TACE) in combination with sorafenib in patients with recurrent hepatocellular carcinoma (HCC) after orthotopic liver transplantation (OLT).
In this multi-center retrospective study, 106 patients with recurrent HCC after OLT were included. Fifty-two patients were treated with TACE plus sorafenib (TS group) and 54 were treated with TACE alone (TC group). Primary and secondary endpoints including overall survival (OS) and progression-free survival (PFS), and safety were assessed.
The median OS (17 vs 10 months, =0.035) and PFS (12 vs 6 months, =0.004) in the TS group were longer than those in the TC group. On multivariate analysis, BCLC stage (HR [hazard ratio]=0.73 [95% CI, 0.27-0.99], =0.036) and sorafenib medication (HR=2.26 [95% CI, 1.35-3.69], =0.01) were identified as independent prognostic risk factors for OS. No severe adverse events related to sorafenib were noted in the TS group. Four patients discontinued sorafenib due to intolerance.
TACE in combination with sorafenib is a feasible regimen to improve the survival with mild toxicity in patients with recurrent HCC after OLT.
探讨经动脉化疗栓塞术（TACE）联合索拉非尼治疗原位肝移植（OLT）术后复发性肝细胞癌（HCC）患者的疗效和安全性。
在这项多中心回顾性研究中，纳入了106例OLT术后复发性HCC患者。52例患者接受TACE联合索拉非尼治疗（TS组），54例患者仅接受TACE治疗（TC组）。评估主要和次要终点，包括总生存期（OS）、无进展生存期（PFS）以及安全性。
TS组的中位OS（17个月对10个月，P = 0.035）和PFS（12个月对6个月，P = 0.004）长于TC组。多因素分析显示，BCLC分期（风险比[HR]=0.73[95%置信区间，0.27 - 0.99]，P = 0.036）和索拉非尼用药（HR = 2.26[95%置信区间，1.35 - 3.69]，P = 0.01）被确定为OS的独立预后风险因素。TS组未观察到与索拉非尼相关的严重不良事件。4例患者因不耐受停用索拉非尼。
TACE联合索拉非尼是一种可行的治疗方案，可提高OLT术后复发性HCC患者的生存率，且毒性轻微。
