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Early on-treatment predictions of clinical outcomes using alpha-fetoprotein and des-gamma-carboxy prothrombin responses in patients with advanced hepatocellular carcinoma

 Myoung Ha Lee  ;  Seung Up Kim  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Eun Hee Choi  ;  Kwang Hun Lee  ;  Do Yun Lee  ;  Jinsil Seong  ;  Kwang-Hyub Han  ;  Chae Yoon Chon  ;  Jun Yong Park 
 Journal of Gastroenterology and Hepatology, Vol.27(2) : 313-322, 2012 
Journal Title
 Journal of Gastroenterology and Hepatology 
Issue Date
Adult ; Aged ; Antineoplastic Agents/administration & dosage* ; Biomarkers/blood* ; Carcinoma, Hepatocellular/blood* ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/therapy* ; Chemoradiotherapy* ; Chi-Square Distribution ; Disease-Free Survival ; Female ; Hepatic Artery ; Humans ; Infusions, Intra-Arterial ; Kaplan-Meier Estimate ; Liver Neoplasms/blood* ; Liver Neoplasms/mortality ; Liver Neoplasms/therapy* ; Male ; Middle Aged ; Proportional Hazards Models ; Protein Precursors/blood* ; Prothrombin ; Republic of Korea ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; Young Adult ; alpha-Fetoproteins/metabolism*
alpha-fetoprotein ; concurrent chemoradiation therapy ; des-gamma-carboxy prothrombin ; hepatic artery hepatocellular carcinoma ; infusional chemotherapy
BACKGROUND AND AIM: The clinical utility of alpha-fetoprotein (AFP) and des-γ-carboxy prothrombin (DCP) as a predictor of treatment outcome in patients with advanced hepatocellular carcinoma (HCC) receiving hepatic artery infusional chemotherapy (HAIC) or concurrent chemoradiation therapy (CCRT) has been poorly defined. METHODS: Between January 2003 and December 2007, we enrolled 127 treatment-naïve patients who received HAIC (n = 60) or CCRT (n = 67) as an initial treatment modality. An AFP or DCP response was defined as a reduction of more than 20% from the baseline level. RESULTS: AFP responders showed significantly better overall survival (OS) than non-responders among patients with HAIC (median 17.3 vs 6.4 months, P < 0.001) and with CCRT (median 17.6 vs 8.7 months, P = 0.014). DCP responders in the CCRT group also showed significantly better progression-free survival (PFS) than non-responders (median 9.2 vs 3.1 months, P < 0.001). Multivariate Cox regression analyses showed that AFP response was independently predictive of OS in both groups (P = 0.009 in HAIC and P = 0.008 in CCRT) whereas DCP only predicted PFS in patients with CCRT (P = 0.015). CONCLUSIONS: Early on-treatment AFP response was predictive of OS in treatment-naïve patients with advanced HCC receiving HAIC and CCRT as an initial treatment modality. Furthermore, DCP response was useful for predicting PFS in patients with CCRT.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 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
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Kwang Hun(이광훈)
Lee, Do Yun(이도연)
Lee, Myoung Ha(이명하)
Chon, Chae Yoon(전재윤)
Choi, Eun Hee(최은희)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
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