Evaluation of dose-efficacy of sorafenib and effect of transarterial chemoembolization in hepatocellular carcinoma patients: a retrospective study

BMC Gastroenterology

Research Article

Hsueh-Chou Lai¹  Cheng-Ju Yu¹  Wang-De Hsiao¹  Wen-Pang Su¹  Ken-Sheng Cheng¹  Po-Heng Chuang¹  Jen-Wei Chou¹  Chun-Lung Feng¹  Sheng-Hung Chen¹  Jung-Ta Kao²  Cheng-Yuan Peng²  Yang-Yuan Chen² 

[1] Division of Hepato-Gastroenterology, Department of Internal Medicine, China Medical University Hospital, No. 2, Yuh-Der Road, 404, Taichung, Taiwan;School of Medicine, China Medical University, Taichung, Taiwan;Division of Hepato-Gastroenterology, Department of Internal Medicine, China Medical University Hospital, No. 2, Yuh-Der Road, 404, Taichung, Taiwan;

关键词: Dose-efficacy;    Sorafenib;    TACE;    Hepatocellular carcinoma patient;   

DOI  :  10.1186/s12876-016-0464-x

 received in 2015-10-27, accepted in 2016-04-15,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundTransarterial chemoembolization (TACE) and sorafenib are the therapeutic standard for intermediate and advanced stage hepatocellular carcinoma (HCC) patients respectively. High costs with adverse events (AE) of sorafenib might limit sorafenib dosage, further affecting therapeutic response. To attain greatest benefit, we evaluated the efficacy of different doses and effect of TACE during and after sorafenib discontinuation in patients representing Child-Pugh Classification Class A with venous or extra-hepatic invasion.MethodsA total 156 patients met the criteria and were divided into Groups I (n = 52) accepting 800 mg/day; II (n = 58) accepting 800 mg/day and reduced to 400 mg/day owing to AE; and III (n = 46) accepting 400 mg/day. TACE was performed during and after sorafenib discontinuation and therapeutic response bimonthly to four-monthly was rated thereafter.ResultsMedian duration of sorafenib treatment and patients’ survival were 4.00 ± 0.45 and 7.50 ± 1.44 months in all cases; 2.50 ± 0.90 and 5.00 ± 1.10 months in Group I; 5.50 ± 1.27 and 16.50 ± 1.86 months in Group II; 4.00 ± 0.94 and 6.50 ± 2.49 months in Group III. Group II presented the best response and survival benefit (p = 0.010 and p = 0.011 respectively). Child-Pugh Classification score 5 (Hazard Ratio = 0.492, p = 0.049), absent AE (3.423, p = 0.015), tumor numbers ≤ 3 (0.313, p = 0.009), sorafenib duration ≤ 1 cycle (3.694, p = 0.004), and absent TACE (3.197, p = 0.008) significantly correlated with patient survival. TACE benefit appeared in separate and total cases during (p = 0.002, p = 0.595, p = 0.074, p = 0.002 respectively) and after discontinuation of sorafenib administration (p = 0.001, p = 0.034, p = 0.647, p = 0.001 respectively).ConclusionsLow-dosage sorafenib not only appeared tolerable and lowered economic pressure but also provided satisfactory results. TACE benefited patient’s survival during and after sorafenib discontinuation.

【 授权许可】

CC BY   
© Hsiao et al. 2016