Liu Shanshan, Han Yunwei, Zhang Zhihong, Wu Fei
Department of General Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Clin Med Insights Oncol. 2023 Feb 22;17:11795549221146648. doi: 10.1177/11795549221146648. eCollection 2023.
Hepatocellular carcinoma (HCC) has insidious onset. Most HCC patients are in advanced stage at the time of initial diagnosis, and the treatment response is poor. The purpose of this study was to compare the clinical effectiveness of conventional transcatheter arterial chemoembolization (c-TACE) combined with sorafenib versus c-TACE monotherapy in the treatment of advanced HCC.
A retrospective analysis was performed on patients with advanced HCC (stage C based on the Barcelona Clinic Liver Cancer staging system) admitted to the Affiliated Hospital of Southwest Medical University from December 9, 2013, to February 25, 2021. After screening for inclusion and exclusion criteria, 120 patients were finally included, including 60 patients in the c-TACE group and 60 patients in c-TACE + sorafenib group. There were no statistically significant differences in general data between the 2 groups before treatment. Overall survival (OS) and progression-free survival (PFS) were compared between the 2 groups, and prognostic factors were assessed by Cox proportional risk model.
The study found that median PFS was 7.37 months in the c-TACE + sorafenib group and 5.97 months in c-TACE group, a statistically significant difference (χ = 5.239, = .022 < .05). The median OS was 22.9 months in the combination group and 12.1 months in c-TACE monotherapy group, also a statistically significant difference (χ = 5.848, = .016 < .05). The Cox proportional risk model found that c-TACE number and presence of ascites were common risk factors among patients in both groups ( < .05).
c-TACE + sorafenib was superior to c-TACE alone in the treatment of advanced HCC and yielded significant improvements in PFS and OS in our study. The number of c-TACE and presence of ascites were common risk factors affecting the survival of patients in the 2 groups.
肝细胞癌（HCC）起病隐匿。大多数HCC患者在初次诊断时已处于晚期，治疗反应较差。本研究的目的是比较传统经动脉化疗栓塞术（c-TACE）联合索拉非尼与单纯c-TACE治疗晚期HCC的临床疗效。
对2013年12月9日至2021年2月25日入住西南医科大学附属医院的晚期HCC患者（根据巴塞罗那临床肝癌分期系统为C期）进行回顾性分析。经筛选纳入和排除标准后，最终纳入120例患者，其中c-TACE组60例，c-TACE+索拉非尼组60例。两组治疗前一般资料比较差异无统计学意义。比较两组的总生存期（OS）和无进展生存期（PFS），并采用Cox比例风险模型评估预后因素。
研究发现，c-TACE+索拉非尼组的中位PFS为7.37个月，c-TACE组为5.97个月，差异有统计学意义（χ=5.239，P=0.022<0.05）。联合组的中位OS为22.9个月，c-TACE单药治疗组为12.1个月，差异也有统计学意义（χ=5.848，P=0.016<0.05）。Cox比例风险模型发现，c-TACE次数和腹水的存在是两组患者的常见危险因素（P<0.05）。
在晚期HCC的治疗中，c-TACE+索拉非尼优于单纯c-TACE，在本研究中其PFS和OS有显著改善。c-TACE次数和腹水的存在是影响两组患者生存的常见危险因素。
