Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, No. 74, Linjiang Road, Yuzhong District, Chongqing Municipality, 400010, People's Republic of China.
Department of Hepatobiliary Pancreatic Tumor Center, Chongqing University Cancer Hospital, Chongqing, No. 181, Hanyu Road, Shapingba District, Chongqing Municipality, 400010, People's Republic of China.
Eur J Med Res. 2024 Sep 19;29(1):465. doi: 10.1186/s40001-024-02053-6.
Portal vein tumor thrombosis (PVTT) commonly occurs in patients with primary liver cancer (PLC). Transarterial chemoembolization (TACE) is a treatment for patients with PLC and PVTT. Some studies have shown that combining TACE therapy with hepatic arterial infusion chemotherapy (HAIC) might improve the survival rate of PLC patients with PVTT. However, few studies have compared the different regimens of PLC with PVTT. We aimed to compare the differences between the oxaliplatin + raltetrexed regimen and FOLFOX regimen.
We divided the 248 patients into two groups. There were 60 patients in the oxaliplatin + ratitetrexed group and 74 patients in the FOLFOX group. The primary endpoints were OS and PFS. The secondary endpoints were ORR and adverse events. We used SPSS software, the Kaplan-Meier method, the t test, and the rank sum test to compare the differences between the two groups.
The median OS was 10.82 months in the oxaliplatin + raltitrexed group and 8.67 months in the FOLFOX group. The median PFS time was greater in the oxaliplatin + raltitrexed group (10.0 months) than that in the FOLFOX group (7.1 months). The ORR was greater in the oxaliplatin + raltitrexed group than that in the FOLFOX group (18.3% vs. 13.5%; P = 0.445). The DCR in the oxaliplatin + raltitrexed group was higher than that in the FOLFOX group (70.0% vs. 64.8%; P = 0.529). However, in the subgroup analysis, the difference between them was more significant in the type II PVTT subgroup. The OS was 12.08 months in the oxaliplatin + raltitrexed group and 7.26 months in the FOLFOX group (P = 0.008). The PFS was 11.68 months in the oxaliplatin + raltitrexed group and 6.26 months in the FOLFOX group (P = 0.014). In the right branch of type II PVTT, the OS was 13.54 months in the oxaliplatin + raltitrexed group and 6.89 months in the FOLFOX group (P = 0.015), and the PFS was 13.35 months in the oxaliplatin + raltitrexed group and 6.27 months in the FOLFOX group (P = 0.030). The incidence of adverse reactions was similar between the two groups.
Compared with the FOLFOX regimen, the oxaliplatin + raltitrexed chemoembolization regimen had longer OS, PFS time and ORR and DCR and it was safe and tolerable.
门静脉癌栓（PVTT）常发生于原发性肝癌（PLC）患者中。经肝动脉化疗栓塞术（TACE）是 PLC 患者的一种治疗方法。一些研究表明，TACE 联合肝动脉灌注化疗（HAIC）可能会提高 PLC 合并 PVTT 患者的生存率。然而，很少有研究比较过 PLC 合并 PVTT 患者的不同治疗方案。我们旨在比较奥沙利铂+雷替曲塞方案和 FOLFOX 方案之间的差异。
我们将 248 例患者分为两组。奥沙利铂+雷替曲塞组 60 例，FOLFOX 组 74 例。主要终点是 OS 和 PFS。次要终点是 ORR 和不良事件。我们使用 SPSS 软件、Kaplan-Meier 方法、t 检验和秩和检验来比较两组之间的差异。
奥沙利铂+雷替曲塞组的中位 OS 为 10.82 个月，FOLFOX 组为 8.67 个月。奥沙利铂+雷替曲塞组的中位 PFS 时间（10.0 个月）长于 FOLFOX 组（7.1 个月）。奥沙利铂+雷替曲塞组的 ORR 高于 FOLFOX 组（18.3% vs. 13.5%；P=0.445）。奥沙利铂+雷替曲塞组的 DCR 高于 FOLFOX 组（70.0% vs. 64.8%；P=0.529）。然而，在亚组分析中，它们之间的差异在 II 型 PVTT 亚组中更为显著。奥沙利铂+雷替曲塞组的 OS 为 12.08 个月，FOLFOX 组为 7.26 个月（P=0.008）。奥沙利铂+雷替曲塞组的 PFS 为 11.68 个月，FOLFOX 组为 6.26 个月（P=0.014）。在 II 型 PVTT 的右支中，奥沙利铂+雷替曲塞组的 OS 为 13.54 个月，FOLFOX 组为 6.89 个月（P=0.015），PFS 分别为 13.35 个月和 6.27 个月（P=0.030）。两组不良反应发生率相似。
与 FOLFOX 方案相比，奥沙利铂+雷替曲塞化疗栓塞方案具有更长的 OS、PFS 时间和 ORR、DCR，且安全耐受。
