Predictive factors for the benefit of triple‐drug transarterial chemoembolization for patients with unresectable hepatocellular carcinoma

Cancer Medicine

MinShan Chen¹  QiJiong Li¹  Ming Shi¹  YaoJun Zhang¹  Wei Wei¹  RongPing Guo¹  MinKe He¹  GuoSheng Tan²  JingXian Shen³  Qing Li⁴  RuHai Zou⁴  JiaYing Lai⁵ 

[1] Department of Hepatobiliary Oncology Sun Yat‐sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine Guangzhou China;Department of Interventional Radiology The First Affiliated Hospital of Sun Yat‐sen University Guangzhou China;Department of Radiology Sun Yat‐sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine Guangzhou China;Department of Ultrasonography Sun Yat‐sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine Guangzhou China;HuiDong Senior Middle School Huidong China;

关键词: overall survival;    predictive factor;    propensity score matching;    single‐drug chemotherapy;    transarterial chemoembolization;    triple‐drug chemotherapy;   

DOI  :  10.1002/cam4.2355

来源: DOAJ

【 摘 要 】

Abstract Background Compared with single‐drug TACE, our previous phase III study demonstrated that triple‐drug transarterial chemoembolization (TACE) prolonged overall survival (OS) in patients with unresectable hepatocellular carcinoma (HCC). The aim of this study was to find which patients can benefit from the triple drugs TACE compared with single‐drug TACE. Methods Patients in the triple‐drug TACE arm received sponge embolization and emulsions composed of 50 mg epirubicin, 50 mg lobaplatin, 6 mg mitomycin C, and lipiodol, while patients in the single‐drug TACE arm received sponge embolization and emulsions composed of 50 mg epirubicin and lipiodol. From July 2007 to November 2009, 244 patients (224 men and 20 women; age ranged from 21 to 75 years) from our phase III study formed the initial cohort. From January 2010 to June 2015, external validation cohort was composed of 449 patients (411 men and 38 women; age ranged from 18 to 75 years) from another institution. The validation cohort after propensity score matching (PSM) (n = 374) was analyzed. Cox proportional hazard model was used to evaluate the interaction term between treatments for each subgroup. This retrospective study was approved by the institutional review board at each center. Results No difference was observed in the baseline characteristic of three cohorts. This exploratory analysis showed that triple‐drug TACE brought a survival benefit in the initial cohort, validation cohort (before PSM), and validation cohort (after PSM) compared with single‐drug TACE. The outcomes of three cohorts all showed that a significantly greater OS triple‐drug chemotherapy benefit versus single‐drug chemotherapy was seen in patients with large tumors (larger than 10 cm) while no survival difference was seen in patients with small tumors (10 cm or smaller). Conclusions Triple‐drug TACE seems to benefit patients with HCC larger than 10 cm in particular compared with single‐drug TACE.

【 授权许可】

Unknown