索拉非尼治疗晚期肝癌患者的现实经验

StephenW

Drug Des Devel Ther. 2019 Jan 22;13:397-404. doi: 10.2147/DDDT.S191334. eCollection 2019.
A real-life experience of sorafenib treatment for patients with advanced hepatocellular carcinoma: a retrospective analysis at Cathay General Hospital, 2007-2015.
Huang CC1, Chen HY1, Chang RH1, Liao PA2, Lien HH3,4, Hung CS5, Yang SS1,3, Hu JT1,3.
Author information

1
    Liver Center, Cathay General Hospital Medical Center, Taipei, Taiwan, [email protected].
2
    Department of Radiology, Cathay General Hospital Medical Center, Taipei, Taiwan.
3
    School of Medicine, Fu-Jen Catholic University College of Medicine, Taipei, Taiwan, [email protected].
4
    Department of Surgery, Cathay General Hospital Medical Center, Taipei, Taiwan.
5
    Department of Gastroenterology, Cathay General Hospital Medical Center, Taipei, Taiwan.

Abstract
Background:

Sorafenib is an oral tyrosine kinase inhibitor that is indicated for advanced hepatocellular carcinoma (HCC). The aim of the present study was to determine the clinical outcomes of HCC patients receiving sorafenib in real-life clinical setting in comparison with formal clinical trials.
Methods:

Patients diagnosed with advanced HCC between 2007 and 2015 at single institute were retrospectively enrolled and evaluated for survival and tolerability following sorafenib treatment. Overall survival (OS) and duration of treatment (TTP) were examined by different stratifications including age, gender, etiology, liver functions, and severities.
Results:

A total of 67 advanced HCC patients were enrolled for analysis. Of the 67 eligible patients, 66 patients (99%) were diagnosed as Barcelona Clinic Liver Cancer stage C and 45 (67%) were Child-Pugh A. Chronic hepatitis B virus infection was the main etiology (67%), followed by hepatitis C virus infection (12%) and alcohol liver disease (8%). The median duration of treatment was 3.0 months (95% CI 2.6-3.4 months) and median OS was 8.0 months (95% CI 5.0-11.0 months). By multivariate analysis, female gender (HR =2.462, 95% CI 1.126-5.387, P=0.024), Child-Pugh C (HR =3.913, 95% CI 1.063-14.410, P=0.04), extrahepatic spread (HR =2.123, 95% CI 1.122-4.015, P=0.021), and combined other therapies (HR =0.410, 95% CI 0.117-0.949, P=0.037) were the independent predictors of OS.
Conclusion:

OS of advanced HCC patients treated with sorafenib was longer than that reported in the Asia-Pacific trial study. Impaired hepatic functions are associated with the shorter survival in real-life setting.
KEYWORDS:

advanced hepatocellular carcinoma; liver function; sorafenib; tumor burden

PMID:
    30774305
PMCID:
    PMC6349409
DOI:
    10.2147/DDDT.S191334

StephenW

Drug Des Devel Ther。 2019年1月22日; 13：397-404。 doi：10.2147 / DDDT.S191334。 eCollection 2019。
索拉非尼治疗晚期肝细胞癌患者的现实经验：2007  -  2015年国泰综合医院回顾性分析。
Huang CC1，Chen HY1，Chang RH1，Liao PA2，Lien HH3,4，Hung CS5，Yang SS1,3，Hu JT1,3。
作者信息

1
    台湾台北国泰综合医院医疗中心肝脏中心[email protected]。
2
    台湾台北国泰综合医院医疗中心放射科
3
    台湾台北市辅仁大学医学院医学院，huyeh0203 @ gmail.com。
4
    台湾台北国泰综合医院医疗中心外科
五
    台湾台北国泰总医院医学中心消化内科。

抽象
背景：

索拉非尼是一种口服酪氨酸激酶抑制剂，适用于晚期肝细胞癌（HCC）。本研究的目的是确定与正式临床试验相比，在现实临床环境中接受索拉非尼的HCC患者的临床结果。
方法：

2007年至2015年在单一研究所诊断为晚期HCC的患者进行了回顾性研究，并评估了索拉非尼治疗后的存活率和耐受性。通过不同的分层检查总生存期（OS）和治疗持续时间（TTP），包括年龄，性别，病因，肝功能和严重程度。
结果：

共招募了67名晚期HCC患者进行分析。在67名符合条件的患者中，66名患者（99％）被诊断为巴塞罗那临床肝癌C期，45名（67％）患儿为Child-Pugh A.慢性乙型肝炎病毒感染是主要病因（67％），其次是肝炎C病毒感染（12％）和酒精性肝病（8％）。中位治疗时间为3.0个月（95％CI 2.6-3.4个月），中位OS​​为8.0个月（95％CI 5.0-11.0个月）。通过多变量分析，女性（HR = 2.462,95％CI 1.126-5.387，P = 0.024），Child-Pugh C（HR = 3.913,95％CI 1.063-14.410，P = 0.04），肝外扩散（HR = 2.123） ，95％CI 1.122-4.015，P = 0.021），并结合其他疗法（HR = 0.410,95％CI 0.117-0.949，P = 0.037）是OS的独立预测因子。
结论：

用索拉非尼治疗的晚期HCC患者的OS比亚太试验研究中报道的要长。肝功能受损与现实生活环境中的生存期较短有关。
关键词：晚期肝细胞癌;肝功能;索拉非尼;肿瘤负担

结论：
    30774305
PMCID：
    PMC6349409
DOI：
    10.2147 / DDDT.S191334