Potential efficacy of therapies targeting intrahepatic lesions after sorafenib treatment of patients with hepatocellular carcinoma.
Potential efficacy of therapies targeting intrahepatic lesions after sorafenib treatment of patients with hepatocellular carcinoma.
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DOI：
10.1186/s12885-016-2380-4
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发表时间：
2016-05-31
期刊：
影响因子：
3.8
通讯作者：
Kaneko S
中科院分区：
文献类型：
--
作者：
Terashima T;Yamashita T;Horii R;Arai K;Kawaguchi K;Kitamura K;Yamashita T;Sakai Y;Mizukoshi E;Honda M;Kaneko S
我们研究了索拉非尼难治性或不耐受的晚期肝细胞癌的后续治疗的贡献。此外，我们使用个体数据研究了索拉非尼对总生存期的影响。我们回顾了索拉非尼治疗晚期肝癌患者的病历。索拉非尼治疗后的生存期和总生存期分别定义为我们发现患者对索拉非尼难治或不耐受的时间和从索拉非尼治疗开始至研究期间死亡的时间。我们根据患者的后续治疗对患者的病情进行了比较：A组，靶向肝内病变治疗; B组，单纯全身治疗; C组，无后续治疗。我们使用线性回归分析来确定索拉非尼治疗后生存率和总生存率是否相关。在79例患者中，63例（79.7%）接受了一种或多种后续治疗（A组和B组分别有44例和19例患者）。5名患者在索拉非尼治疗停止后存活超过2年，对靶向肝内病变的治疗有反应。A、B和C组的中位生存时间分别为11.9个月、5.8个月和3.6个月。多因素分析显示A组、Child-Pugh评分、血清甲胎蛋白水平和索拉非尼治疗失败原因是索拉非尼治疗后生存的独立预后因素。索拉非尼治疗后的个体生存率与总生存率高度相关。靶向肝内病变可能有助于治疗索拉非尼治疗停止后的晚期肝癌患者。本文的在线版本（doi：10.1186/s12885-016-2380-4）包含补充材料，可供授权用户使用。
We investigated the contribution of subsequent therapy for advanced hepatocellular carcinoma refractory or intolerant to sorafenib. Further, we investigated the impact of sorafenib on overall survival using individual data. We reviewed the medical records of patients with advanced hepatocellular carcinoma treated with sorafenib. Survival after sorafenib treatment and overall survival were defined as the time when we discovered that patients were either refractory or intolerant to sorafenib and the period from the start of sorafenib treatment, respectively, until death during the study. We compared patients’ prognoses according to their subsequent treatment as follows: group A, therapies targeting intrahepatic lesions; group B, systemic therapies alone; group C, no subsequent therapy. We used linear regression analysis to determine whether there was an association with survival after sorafenib treatment and with overall survival. Of 79 patients, 63 (79.7 %) received one or more subsequent therapies (44 and 19 patients in groups A and B, respectively). The five patients who survived more than two years after sorafenib treatment was discontinued responded to therapies targeting intrahepatic lesions. The median survival times of groups A, B, and C were 11.9 months, 5.8 months, and 3.6 months, respectively. Multivariate analysis revealed that group A, Child-Pugh score, serum α-fetoprotein level, and cause of failure of sorafenib treatment were independent prognostic factors for survival after sorafenib treatment. Individual survival after sorafenib treatment correlated highly with overall survival. Targeting intrahepatic lesions may be useful for treating patients with advanced hepatocellular carcinoma patients after sorafenib treatment is discontinued. The online version of this article (doi:10.1186/s12885-016-2380-4) contains supplementary material, which is available to authorized users.