Radiology · 2012
Advanced-stage hepatocellular carcinoma: transarterial chemoembolization versus sorafenib.
Сравнительное исследованиеСтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Pinter Matthias, Hucke Florian, Graziadei Ivo, Vogel Wolfgang, Maieron Andreas, Königsberg Robert, Stauber Rudolf, Grünberger Birgit, Müller Christian, Kölblinger Claus, Peck-Radosavljevic Markus, Sieghart Wolfgang
Аннотация
PURPOSE: To compare the efficacies of transarterial chemoembolization (TACE) and sorafenib in patients with advanced-stage hepatocellular carcinoma (HCC).
MATERIALS AND METHODS: The retrospective analysis of the data was approved by the institutional review board; the requirement to obtain informed consent was waived. Three hundred seventy-two patients with HCC were treated between January 1999 and December 2009. Patients with advanced HCC according to the Barcelona Clinic Liver Cancer (BCLC) staging classification (Child-Pugh class A or B, Eastern Cooperative Oncology Group performance status of 1-2, and/or macrovascular invasion or extrahepatic metastasis) were included in the study (n = 97). Thirty-four patients underwent conventional TACE with doxorubicin plus lipiodol or TACE with drug-eluting beads; 63 patients were treated with sorafenib.
RESULTS: The median duration of sorafenib treatment was 4.6 months (95% confidence interval [CI]: 3.2, 6.0 months). The median number of TACE sessions per patient was 3 ± 2. Side effects of TACE and sorafenib were comparable to those reported in the literature. The median time to progression was similar between the two treatment groups (P = .737). The median overall survival was 9.2 months (95% CI: 6.1, 12.3 months) for patients treated with TACE and 7.4 months (95% CI: 5.6, 9.2 months) for those treated with sorafenib (P = .377). Only Child-Pugh class was associated with a better overall survival at uni- and multivariate analysis.
CONCLUSION: TACE achieved a promising outcome in select patients with advanced HCC (BCLC stage C).
MATERIALS AND METHODS: The retrospective analysis of the data was approved by the institutional review board; the requirement to obtain informed consent was waived. Three hundred seventy-two patients with HCC were treated between January 1999 and December 2009. Patients with advanced HCC according to the Barcelona Clinic Liver Cancer (BCLC) staging classification (Child-Pugh class A or B, Eastern Cooperative Oncology Group performance status of 1-2, and/or macrovascular invasion or extrahepatic metastasis) were included in the study (n = 97). Thirty-four patients underwent conventional TACE with doxorubicin plus lipiodol or TACE with drug-eluting beads; 63 patients were treated with sorafenib.
RESULTS: The median duration of sorafenib treatment was 4.6 months (95% confidence interval [CI]: 3.2, 6.0 months). The median number of TACE sessions per patient was 3 ± 2. Side effects of TACE and sorafenib were comparable to those reported in the literature. The median time to progression was similar between the two treatment groups (P = .737). The median overall survival was 9.2 months (95% CI: 6.1, 12.3 months) for patients treated with TACE and 7.4 months (95% CI: 5.6, 9.2 months) for those treated with sorafenib (P = .377). Only Child-Pugh class was associated with a better overall survival at uni- and multivariate analysis.
CONCLUSION: TACE achieved a promising outcome in select patients with advanced HCC (BCLC stage C).
Предметные рубрики MeSH
AdultAgedAntineoplastic AgentsBenzenesulfonatesBiomarkers, TumorCarcinoma, HepatocellularChemoembolization, TherapeuticChi-Square DistributionContrast MediaDisease ProgressionDoxorubicinEthiodized OilFemaleHumansLiver NeoplasmsMagnetic Resonance ImagingMaleMiddle AgedNeoplasm StagingNiacinamidePhenylurea CompoundsProportional Hazards ModelsPyridinesRetrospective StudiesSorafenibSurvival AnalysisTomography, X-Ray ComputedTreatment Outcome