Eastern Hepatobiliary Surgery Hospital, the Second Military Medical University, Shanghai 200438, China.
Acta Pharmacol Sin. 2010 Dec;31(12):1643-8. doi: 10.1038/aps.2010.124. Epub 2010 Nov 22.
to determine the efficacy and toxicities of sorafenib in the treatment of patients with multiple recurrences of hepatocellular carcinoma (HCC) after liver transplantation in a Chinese population.
twenty patients with multiple recurrences of HCC after liver transplantation were retrospectively studied. They received either transarterial chemoembolization (TACE) or TACE combined with sorafenib.
the median survival times (MST) after multiple recurrences was 14 months (TACE+sorafenib group) and 6 months (TACE only group). The difference was significant in MST between the two groups (P=0.005). The TACE + sorafenib group had more stable disease (SD) patients than the TACE group. The most frequent adverse events of sorafenib were hand-foot skin reaction and diarrhea. In the univariate analysis, preoperative bilirubin and CHILD grade are found to be significantly associated with tumor-free survival time, the survival time after multiple recurrences and overall survival time. TACE+sorafenib group showed a better outcome than single TACE treatment group. In the multivariate COX regression modeling, the preoperative high CHILD grade was found to be a risk factor of tumor-free survival time. In addition, the preoperative high bilirubin grade was also found to be a risk factor of survival time after recurrence and overall survival time. Furthermore, survival time after recurrence and overall survival time were also associated with therapeutic schedule, which was indicated by the GROUP.
Treatment with TACE and sorafenib is worthy of further study and may have more extensive application prospects.
评估索拉非尼治疗中国人肝移植术后多次复发肝癌的疗效和毒性。
回顾性研究 20 例肝移植术后多次复发 HCC 患者,采用经肝动脉化疗栓塞(TACE)或 TACE 联合索拉非尼治疗。
多次复发后的中位生存时间(MST)分别为 14 个月(TACE+索拉非尼组)和 6 个月(TACE 组)。两组 MST 差异有统计学意义(P=0.005)。TACE+索拉非尼组稳定疾病(SD)患者多于 TACE 组。索拉非尼最常见的不良反应是手足皮肤反应和腹泻。单因素分析发现,术前胆红素和 CHILD 分级与无瘤生存时间、多次复发后生存时间和总生存时间显著相关。TACE+索拉非尼组的疗效优于单纯 TACE 组。多因素 COX 回归模型分析发现,术前高 CHILD 分级是无瘤生存时间的危险因素。此外,术前高胆红素分级也是复发后生存时间和总生存时间的危险因素。进一步的生存分析显示,治疗方案(GROUP)与复发后生存时间和总生存时间相关。
TACE 联合索拉非尼治疗值得进一步研究,可能具有更广泛的应用前景。