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Randomized, prospective, comparative study on the effects and safety of sorafenib vs. hepatic arterial infusion chemotherapy in patients with advanced hepatocellular carcinoma with portal vein tumor thrombosis

Authors
 Jong Hwan Choi  ;  Woo Jin Chung  ;  Si Hyun Bae  ;  Do Seon Song  ;  Myeong Jun Song  ;  Young Seok Kim  ;  Hyung Joon Yim  ;  Young Kul Jung  ;  Sang Jun Suh  ;  Jun Yong Park  ;  Do Young Kim  ;  Seung Up Kim  ;  Sung Bum Cho 
Citation
 CANCER CHEMOTHERAPY AND PHARMACOLOGY, Vol.82(3) : 469-478, 2018 
Journal Title
 CANCER CHEMOTHERAPY AND PHARMACOLOGY 
ISSN
 0344-5704 
Issue Date
2018
MeSH
Administration, Oral ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage* ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Carcinoma, Hepatocellular/complications ; Carcinoma, Hepatocellular/drug therapy* ; Catheters, Indwelling ; Cisplatin/administration & dosage ; Cisplatin/adverse effects ; Female ; Fluorouracil/administration & dosage ; Fluorouracil/adverse effects ; Humans ; Infusions, Intra-Arterial ; Liver Neoplasms/complications ; Liver Neoplasms/drug therapy* ; Male ; Middle Aged ; Portal Vein/pathology* ; Prospective Studies ; Sorafenib/administration & dosage* ; Sorafenib/adverse effects ; Survival Rate ; Venous Thrombosis/complications ; Venous Thrombosis/pathology ; Venous Thrombosis/physiopathology*
Keywords
Hepatic arterial infusion chemotherapy ; Hepatocellular carcinoma ; Portal vein tumor thrombosis ; Prognosis ; Sorafenib
Abstract
BACKGROUND/AIMS: Treatment responses of advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) remain unacceptably low and treatment modalities are limited. We compared the efficacy and safety of sorafenib and hepatic arterial infusion chemotherapy (HAIC). METHODS: In this randomized, prospective, comparative study, data on 58 patients with advanced HCC with PVTT, with Child-Turcotte-Pugh (CTP) scores of 5-7, were collected from six university hospitals between January 2013 and October 2015. Twenty-nine patients were treated with sorafenib and twenty-nine with HAIC. RESULTS: The median overall survival (OS) and time to progression (TTP) were significantly longer in the HAIC group than in the sorafenib group (14.9 vs.7.2 months, p = 0.012 and 4.4 vs. 2.7 months, p = 0.010). The objective response (OR) rates were 27.6 and 3.4% in the HAIC and sorafenib groups, respectively (p = 0.001). In univariate analysis, sex, main portal vein invasion and treatment modality were significant prognostic factors of OS (p = 0.044, 0.040, 0.015), whereas cause of HCC, tumor number, tumor location and treatment modality were significant prognostic factors of TTP (p = 0.040, 0.002, 0.034, 0.014). In multivariate analysis, sex and treatment modality were significant prognostic factors of OS (p = 0.008, 0.005), whereas cause of HCC, tumor number, tumor location and treatment modality were significant prognostic factors of TTP (p = 0.038, 0.038, 0.015, 0.011). Major complications included hyperbilirubinemia (44.8%), AST elevation (34.5%), ascites (13.8%) and catheter-related complications (3.4%) in the HAIC group and hyperbilirubinemia (34.5%), hand-foot syndrome (31.0%) and AST elevation (27.6%) in the sorafenib group. CONCLUSIONS: For managing advanced HCC with PVTT, HAIC may be a valuable treatment modality.
Full Text
https://link.springer.com/article/10.1007%2Fs00280-018-3638-0
DOI
10.1007/s00280-018-3638-0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/172969
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