Overall survival in response to sorafenib versus radiotherapy in unresectable hepatocellular carcinoma with major portal vein tumor thrombosis: propensity score analysis

BMC Gastroenterology

Research Article

Tsutomu Minamino¹  Akitaka Shibuya¹  Wasaburo Koizumi¹  Juichi Takada¹  Masaaki Watanabe¹  Hisashi Hidaka¹  Yusuke Okuwaki¹  Yoshiaki Tanaka¹  Takahide Nakazawa²  Shigehiro Kokubu³ 

[1] Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, 2-1-1 Asamizodai, Minami-ku, 252-0380, Sagamihara, Kanagawa, Japan;Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, 2-1-1 Asamizodai, Minami-ku, 252-0380, Sagamihara, Kanagawa, Japan;Nakazawa Medical Clinic, Sagamihara, Japan;Department of Gastroenterology, Juntendo University Nerima Hospital, Tokyo, Japan;

关键词: Hepatocellular carcinoma;    Overall survival;    Portal venous tumor thrombosis;    Radiotherapy;    Sorafenib;   

DOI  :  10.1186/1471-230X-14-84

 received in 2014-01-27, accepted in 2014-04-29,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundThis study investigated the survival benefits of sorafenib vs. radiotherapy (RT) in patients with unresectable hepatocellular carcinoma (HCC) and portal vein tumor thrombosis (PVTT) in the main trunk or the first branch.MethodsNinety-seven patients were retrospectively reviewed. Forty patients were enrolled by the Kanagawa Liver Study Group and received sorafenib, and 57 consecutive patients received RT in our hospital. Overall survival was compared between the two groups with PVTT by propensity score (PS) analysis. Factors associated with survival were evaluated by multivariate analysis.ResultsThe median treatment period with sorafenib was 45 days, while the median total radiation dose was 50 Gy. The Child-Pugh class and the level of invasion into hepatic large vessels were significantly more advanced in the RT group than in the sorafenib group. Median survival did not differ significantly between the sorafenib group (4.3 months) and the RT group (5.9 months; P = 0.115). After PS matching (n = 28 per group), better survival was noted in the RT group than in the sorafenib group (median survival, 10.9 vs. 4.8 months; P = 0.025). A Cox model showed that des-γ-carboxy prothrombin <1000 mAU/mL at enrollment and RT were significant independent predictors of survival in the PS model (P = 0.024, HR, 0.508; 95% CI, 0.282 to 0.915; and P = 0.007, HR, 0.434; 95% CI, 0.235 to 0.779; respectively).ConclusionsRT is a better first-line therapy than sorafenib in patients who have advanced unresectable HCC with PVTT.

【 授权许可】

CC BY   
© Nakazawa et al.; licensee BioMed Central Ltd. 2014