采用FOLFOX方案经动脉灌注化疗治疗晚期肝细胞癌：一项多中心倾向评分匹配的真实世界实践分析
Transarterial infusion chemotherapy with FOLFOX for advanced hepatocellular carcinoma: a multi-center propensity score matched analysis of real-world practice.
作者信息
Li Shaohua, Mei Jie, Wang Qiaoxuan, Shi Feng, Liu Hongyan, Zhao Ming, Lu Lianghe, Ling Yihong, Guo Zhixing, Guo Yabing, Chen Xiaoming, Shi Ming, Lau Wan Yee, Wei Wei, Guo Rongping
机构信息
Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
出版信息
Hepatobiliary Surg Nutr. 2021 Oct;10(5):631-645. doi: 10.21037/hbsn.2020.03.14.
BACKGROUND
To compare the treatment effectiveness and safety among transarterial infusion chemotherapy (TAI) with FOLFOX regimen, transarterial chemoembolization (TACE), and sorafenib in patients with BCLC stage C hepatocellular carcinoma (HCC).
METHODS
The data of consecutive patients with BCLC stage C HCC treated with TAI, TACE, or sorafenib from January 2015 to December 2018 at three centers were retrospectively analyzed. Propensity-score matched (PSM) analysis was pairwise performed to reduce selection bias. Treatment effectiveness and safety were evaluated and compared using the Kaplan-Meier method, log-rank test, Cox regression models, and χ test.
RESULTS
The median overall survival (OS) in the matched TAI cohort was significantly longer than the sorafenib cohort (19.6 7.5 months, P=0.009), and the TACE cohort (estimated 27.8 6.6 months, P<0.001). The difference in median progression-free survival (PFS) between the matched TAI and sorafenib cohorts was not significant (5.8 . 2.3 months, P=0.219). The median PFS in the matched TAI cohort was significantly longer than the TACE cohort (6.5 . 2.8 months, P<0.001). The objective response rate (ORR) in the matched TAI cohort was significantly higher than the sorafenib cohort (36.4% . 0.0%, P<0.001) and the TACE cohort (48.7% . 4.7%, P<0.001). The incidences of adverse events (AEs) were similar among these three cohorts.
CONCLUSIONS
TAI with FOLFOX regimen was an effective and safe therapy that improved survival of patients with BCLC stage C HCC.
背景
比较经动脉灌注化疗（TAI）联合FOLFOX方案、经动脉化疗栓塞（TACE）及索拉非尼治疗BCLC C期肝细胞癌（HCC）患者的疗效及安全性。
方法
回顾性分析2015年1月至2018年12月在三个中心接受TAI、TACE或索拉非尼治疗的连续性BCLC C期HCC患者的数据。进行倾向评分匹配（PSM）分析以减少选择偏倚。采用Kaplan-Meier法、对数秩检验、Cox回归模型及χ检验评估并比较疗效及安全性。
结果
匹配后的TAI队列中位总生存期（OS）显著长于索拉非尼队列（19.6±7.5个月，P = 0.009）及TACE队列（估计27.8±6.6个月，P<0.001）。匹配后的TAI与索拉非尼队列之间的中位无进展生存期（PFS）差异无统计学意义（5.8±2.3个月，P = 0.219）。匹配后的TAI队列中位PFS显著长于TACE队列（6.5±2.8个月，P<0.001）。匹配后的TAI队列客观缓解率（ORR）显著高于索拉非尼队列（36.4% vs 0.0%，P<0.001）及TACE队列（48.7% vs 4.7%，P<0.001）。这三个队列的不良事件（AE）发生率相似。
结论
TAI联合FOLFOX方案是一种有效且安全的治疗方法，可提高BCLC C期HCC患者的生存率。
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