高基线HBV负荷和抗病毒治疗的影响的晚期患者HBV相关肝癌索

StephenW

A high baseline HBV load and antiviral therapy affect the survival of patients with advanced HBV-related HCC treated with sorafenib

    Yu Yang1,†, Feng Wen1,†, Jianliang Li2,†, Pengfei Zhang1,†, Wenhui Yan3, Ping Hao4, Feng Xia5, Feng Bi1 andQiu Li1,*

Article first published online: 7 MAR 2015

DOI: 10.1111/liv.12805

© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Issue
Liver International

Volume 35, Issue 9, pages 2147–2154, September 2015

    1    The Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
    2    The Department of Medical Oncology, Hunan Cancer Hospital/The Affiliated Tumor Hospital of Xiangya School of Medicine, Central South University, Changsha, China
    3    The Department of Medical Oncology, Second People's Hospital of Hunan Province, Changsha, China
    4    The Department of Oncology, Xinqiao Hospital, The Third Military Medical University, Chongqing, China
    5    The Department of Hepatobiliary Surgery, Southwest Hospital, Chongqing, China

    †    These authors contributed equally to this work.

* Correspondence
Dr. and Prof. Q. Li, The Department of Medical Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, Sichuan 610041, China
Tel: +86 28 85423609
Fax: +86 28 85423262
e-mail: [email protected]

  
Keywords:

    antiviral therapy;hepatitis B;hepatocellular carcinoma;sorafenib;viral load

Abstract
Background and Aims

Although a high viral load is an independent risk factor for recurrence of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after surgery, the prognostic impact of viral load on advanced HCC is unclear. This study investigated the impact of baseline HBV load and antiviral therapy on survival of patients with advanced HCC treated with sorafenib.
Methods

Of 130 patients with advanced HBV-related HCC received first-line sorafenib therapy were evaluated in a multicenter, retrospective study.
Results

No patients experienced severe hepatic impairment because of HBV reactivation during sorafenib therapy. The median progression-free survival (PFS) and overall survival (OS) of all patients were 5.7 and 9.6 months respectively. Patients with a baseline HBV DNA ≤104 copies/ml had significantly better OS than those with >104 copies/ml (10.4 vs 6.6 months; P = 0.002), but PFS showed an increasing trend (5.8 vs 4.8 months; P = 0.068). Patients who received antiviral therapy had a better trend in OS than those who did not (12.0 vs 8.3 months; P = 0.058), but there was no difference in PFS (6.4 vs 4.1 months; P = 0.280). In a multivariate analysis, the baseline HBV DNA level >104 copies/ml (P = 0.001; hazard ration [HR] = 2.294; 95% CI 1.429–3.676) and antiviral therapy (P = 0.038; HR 0.617; 95% CI 0.390–0.975) were independent predictors of OS.
Conclusion

In patients with advanced HBV-related HCC treated with sorafenib, a high baseline HBV load was an adverse prognostic factor for survival. However, survival was significantly improved with the use of antiviral therapy.

StephenW

高基线HBV负荷和抗病毒治疗的影响的晚期患者HBV相关肝癌索拉非尼治疗的生存期

    宇扬1，†，冯雯，†，建良力2，†，鹏飞Zhang1，†，文汇Yan3，平Hao4，冯Xia5，冯BI1 andQiu丽1，*

文章首次在线发表：2015年3月7日

DOI：10.1111 / liv.12805

2015年©约翰·威利父子A / S。由John Wiley＆Sons出版有限公司

问题
肝国际

第35卷，第9期，页2147至2154年，2015年9月

    肿瘤内科，肿瘤中心，中国西部医院，四川大学，成都，中国的1系
    2肿瘤内科，湖南省肿瘤医院/中南大学湘雅医学院，湖南长沙，中国的附属肿瘤医院的部
    肿瘤内科的3系，湖南省，长沙市，中国第二人民医院
    4肿瘤，新桥医院，第三军医大学，重庆，中国的部
    肝胆外科的5系，西南医院，重庆，中国

    †这些作者贡献同样对这项工作。

*通讯
博士和教授问：李，肿瘤内科，肿瘤中心，生物治疗国家重点实验室，中国西部医院，四川大学，第37号部，郭薛祥，四川成都610041，中国
电话：+86 28 85423609
传真：+86 28 85423262
电子邮件：[email protected]

  
关键词：

    抗病毒治疗;乙型肝炎;肝细胞癌;索拉非尼，病毒载量

抽象
背景和目的

手术后虽然较高的病毒载量为复发乙型肝炎病毒的独立危险因素（HBV）相关的肝细胞癌（HCC），病毒载量的对晚期HCC的预后影响尚不清楚。本研究探讨基线HBV负荷和抗病毒治疗对患者的生存期与索拉非尼治疗晚期肝癌的影响。
方法

130例晚期HBV相关HCC接收的第一线索拉非尼治疗的多中心，回顾性研究进行了评价。
结果

无一例患者因在索拉非尼治疗HBV再严重肝损伤。所有患者的中位无进展生存期（PFS）和总生存期（OS）分别为5.7和9.6个月。患者的基线HBV DNA≤104拷贝/ ml具有比那些与> 104拷贝/ ml显著更好的OS（10.4 VS6.6个月; P = 0.002），但PFS呈逐年上升的趋势（5.8 VS4.8个月; P = 0.068） 。谁接受抗病毒治疗的患者曾在操作系统更好的趋势，谁比那些没有（12.0 VS8.3个月; P = 0.058），但在PFS无差异（6.4 VS4.1个月; P = 0.280）。在多变量分析，基线HBV DNA水平> 104拷贝/ ml（P = 0.001;危险比[HR] = 2.294; 95％CI 1.429-3.676）和抗病毒治疗（P = 0.038; HR 0.617; 95％CI 0.390 -0.975）为OS的独立预测因子。
结论

患者的索拉非尼治疗晚期HBV相关肝癌，高基线HBV负荷是生存预后不良的因素。然而，存活显著与使用抗病毒治疗的改善。

682256

越来越多文献指向一个结论:慢性乙肝高病毒载量，加剧了病情恶化风险。

682256

抑制病毒，降低病毒载量，是改善病情的，降低病情恶化风险必走之路。