Diarrhea Is a Positive Outcome Predictor for Sorafenib Treatment of Advanced Hepatocellular Carcinoma
Diarrhea Is a Positive Outcome Predictor for Sorafenib Treatment of Advanced Hepatocellular Carcinoma
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DOI：
10.1159/000342425
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发表时间：
2013-01-01
期刊：
影响因子：
3.5
通讯作者：
Ganten, Tom M.
中科院分区：
文献类型：
--
作者：
Koschny, Ronald;Gotthardt, Daniel;Ganten, Tom M.
目的：本研究旨在确定接受索拉非尼治疗的晚期肝细胞癌（HCC）患者更好生存的临床预测因子。方法：2007年12月至2010年1月期间，46例晚期HCC患者接受索拉非尼治疗，直至出现明显的肿瘤进展或无法耐受的毒性。我们前瞻性地收集了临床基线数据以及索拉非尼毒副作用的发生率和严重程度的数据，分别与无进展生存期和总生存期（OS）相关。结果：只有 26.1% (n = 12) 的患者能够耐受索拉非尼而不需要减少剂量。最常见的3级毒性是腹泻（32.6%）、手足皮肤反应（13.0%）、疲劳（4.3%）和恶心/呕吐（2.2%）。东部肿瘤合作组的表现状态 (p = 0.034) 和门静脉浸润 (p = 0.021) 与 OS 显着相关。此外，我们发现 OS 与 2 级或 3 级腹泻的出现之间存在显着相关性，中位精算生存期为 11.8 个月（95% CI 6.9-16.6），而 0 级或 1 级腹泻患者的中位生存期为 4.2 个月（95% CI 0.0-9.1；p = 0.009）。相比之下，手足皮肤反应的出现与无进展生存期和 OS 均不相关。结论：出现 2 级或 3 级腹泻表明接受索拉非尼治疗的 HCC 患者具有更好的 OS。版权所有 (C) 2012 S. Karger AG，巴塞尔
Objective: This study was performed to identify clinical predictors for better survival in patients with advanced hepatocellular carcinoma (HCC) under sorafenib treatment. Methods: Between December 2007 and January 2010, 46 patients with advanced HCC were treated with sorafenib until significant tumor progression or intolerable toxicity. We prospectively collected clinical baseline data as well as data on the incidence and severity of toxic side effects of sorafenib to be correlated with progression-free survival and overall survival (OS), respectively. Results: Only 26.1% (n = 12) of patients tolerated sorafenib without requiring dose reduction. The most frequent grade 3 toxicities were diarrhea (32.6%), hand-foot skin reaction (13.0%), fatigue (4.3%), and nausea/vomiting (2.2%). Eastern Cooperative Oncology Group performance status (p = 0.034) and portal vein infiltration (p = 0.021) significantly correlated with OS. Furthermore, we found a significant correlation between OS and appearance of grade 2 or 3 diarrhea with a median actuarial survival of 11.8 months (95% CI 6.9-16.6) compared to 4.2 months in patients with grade 0 or 1 diarrhea (95% CI 0.0-9.1; p = 0.009). In contrast, appearance of hand-foot skin reaction did neither correlate with progression-free survival nor with OS. Conclusion: Appearance of grade 2 or 3 diarrhea indicates a better OS of HCC patients undergoing sorafenib treatment. Copyright (C) 2012 S. Karger AG, Basel