Isowa Masahide, Hamaguchi Reo, Narui Ryoko, Morikawa Hiromasa, Wada Hiromi
Japanese Society on Inflammation and Metabolism in Cancer, Nakagyo-ku, Kyoto, Japan.
Front Oncol. 2023 May 29;13:1179049. doi: 10.3389/fonc.2023.1179049. eCollection 2023.
In hepatocellular carcinoma (HCC) patients, is difficult to prevent recurrence even when remission is achieved. In addition, even with the advent of drugs that are effective for the treatment of HCC, a satisfactory extension of patient survival has not been achieved. To overcome this situation, we hypothesized that the combination of alkalization therapy with standard treatments will improve the prognosis of HCC. We here report the clinical results of HCC patients treated with alkalization therapy at our clinic.
Patients with HCC treated at Karasuma Wada Clinic (in Kyoto, Japan), from January 1, 2013, to December 31, 2020 were analyzed. Overall survival (OS) from both the time of diagnosis and the start of alkalization therapy for each patient was compared. The mean urine pH was also calculated as a surrogate marker of tumor microenvironment pH, and OS from the start of alkalization therapy was compared between patients with a mean urine pH of ≥ 7.0 and those with a mean urine pH of < 7.0.
Twenty-three men and six women were included in the analysis, with a mean age at diagnosis of 64.1 years (range: 37-87 years). Seven of the 29 patients had extrahepatic metastases. Patients were divided into two groups according to their mean urine pH after the initiation of alkalization therapy: 12 of the 29 patients had a mean urine pH of ≥ 7.0, and 17 had a mean urine pH of < 7.0. The median OS from diagnosis was 95.6 months (95% confidence interval [CI] = 24.7-not reached), and from the start of alkalization therapy was 42.3 months (95% CI = 8.93-not reached). The median OS from the start of alkalization therapy in patients with a urine pH of ≥ 7.0 was not reached (n = 12, 95% CI = 3.0-not reached), which was significantly longer than that in patients with a pH of < 7.0 (15.4 months, n = 17, 95% CI = 5.8-not reached, < 0.05).
The addition of alkalization therapy to standard therapies may be associated with more favorable outcomes in HCC patients with increased urine pH after alkalization therapy.
在肝细胞癌（HCC）患者中，即使实现缓解也难以预防复发。此外，即使出现了对HCC治疗有效的药物，患者生存期的满意延长仍未实现。为克服这种情况，我们假设碱化疗法与标准治疗相结合将改善HCC的预后。我们在此报告在我们诊所接受碱化疗法治疗的HCC患者的临床结果。
分析了2013年1月1日至2020年12月31日在日本京都乌丸和田诊所接受治疗的HCC患者。比较了每位患者从诊断时和碱化疗法开始时的总生存期（OS）。还计算了平均尿液pH值作为肿瘤微环境pH值的替代标志物，并比较了平均尿液pH值≥7.0的患者和平均尿液pH值<7.0的患者从碱化疗法开始时的OS。
分析纳入了23名男性和6名女性，诊断时的平均年龄为64.1岁（范围：37 - 87岁）。29名患者中有7名有肝外转移。根据碱化疗法开始后的平均尿液pH值将患者分为两组：29名患者中有12名平均尿液pH值≥7.0，17名平均尿液pH值<7.0。从诊断开始的中位OS为95.6个月（95%置信区间[CI]=24.7 - 未达到），从碱化疗法开始时的中位OS为42.3个月（95%CI = 8.93 - 未达到）。尿液pH值≥7.0的患者从碱化疗法开始时的中位OS未达到（n = 12，95%CI = 3.0 - 未达到），这显著长于pH值<7.0的患者（15.4个月，n = 17，95%CI = 5.8 - 未达到，P<0.05）。
在碱化疗法后尿液pH值升高的HCC患者中，在标准治疗基础上加用碱化疗法可能与更有利的结果相关。
