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Efficacy of Sorafenib Monotherapy versus Sorafenib-Based Loco-Regional Treatments in Advanced Hepatocellular Carcinoma

Authors
 Sangheun Lee  ;  Beom Kyung Kim  ;  Seung Up Kim  ;  Yehyun Park  ;  Sooyun Chang  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Chae Yoon Chon  ;  Kwang-Hyub Han 
Citation
 PLOS ONE, Vol.8(10) : e77240, 2013 
Journal Title
 PLOS ONE 
Issue Date
2013
MeSH
Carcinoma, Hepatocellular/drug therapy* ; Carcinoma, Hepatocellular/pathology* ; Cohort Studies ; Disease-Free Survival ; Female ; Humans ; Kaplan-Meier Estimate ; Liver Neoplasms/drug therapy* ; Liver Neoplasms/pathology* ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Metastasis ; Neoplasm Staging ; Niacinamide/analogs & derivatives* ; Niacinamide/therapeutic use ; Phenylurea Compounds/therapeutic use* ; Treatment Outcome ; alpha-Fetoproteins/metabolism
Keywords
Carcinoma, Hepatocellular/drug therapy* ; Carcinoma, Hepatocellular/pathology* ; Cohort Studies ; Disease-Free Survival ; Female ; Humans ; Kaplan-Meier Estimate ; Liver Neoplasms/drug therapy* ; Liver Neoplasms/pathology* ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Metastasis ; Neoplasm Staging ; Niacinamide/analogs & derivatives* ; Niacinamide/therapeutic use ; Phenylurea Compounds/therapeutic use* ; Treatment Outcome ; alpha-Fetoproteins/metabolism
Abstract
BACKGROUND: Although sorafenib is accepted as the standard of care in advanced hepatocellular carcinoma (HCC), its therapeutic benefit is marginal. Here, we aimed to compare the efficacy and safety of sorafenib monotherapy (S-M) and sorafenib-based loco-regional treatments (S-LRTs) in advanced HCC. METHODS: From 2007 to 2012, 290 patients with advanced HCC (Barcelona Clinic Liver Cancer stage C) with S-M (n = 226) or S-LRTs (n = 64) were reviewed retrospectively. Survival outcomes and treatment-related toxicities between two groups were analyzed. RESULTS: Variables related to tumor burden and liver function were similar between the groups (all P > 0.05). Within the entire population, the S-LRTs group had both longer median overall survival (OS) (8.5 vs 5.5 months, P = 0.001) and progression-free survival (PFS) (5.3 vs 3.0 months, P = 0.002) than the S-M group. Furthermore, the S-LRTs group had longer Os than the S-M group in a subgroup with neither extrahepatic spread (EHS) nor regional nodal involvement (RNI) (18.0 vs 7.8 months, P = 0.019) and in a subgroup with EHS and/or RNI (8.3 vs 4.8 months, P = 0.028). In addition, the S-LRTs group had longer PFS than the S-M group in the subgroup with neither EHS nor RNI (9.6 vs 3.2 months, P = 0.027). TREATMENT: Related toxicity was similar between two groups. CONCLUSION: Combined use of sorafenib and LRTs may provide better treatment outcomes without significantly increasing treatment-related toxicities, even in patients with EHS and/or RNI. Therefore, addition of active LRTs might be considered, if feasible.
Files in This Item:
T201304069.pdf Download
DOI
10.1371/journal.pone.0077240
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
7. Others (기타) > Dept. of Health Promotion (건강의학과) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Park, Yehyun(박예현) ORCID logo https://orcid.org/0000-0001-8811-0631
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Sang Heun(이상헌)
Chang, Soo Yun(장수연)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/88497
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