Early Relative Change in Hepatic Function with Lenvatinib for Unresectable Hepatocellular Carcinoma
Early Relative Change in Hepatic Function with Lenvatinib for Unresectable Hepatocellular Carcinoma
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DOI：
10.1159/000502095
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发表时间：
2019-12-01
期刊：
影响因子：
3.5
通讯作者：
Michitaka, Kojiro
中科院分区：
文献类型：
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作者：
Hiraoka, Atsushi;Kumada, Takashi;Michitaka, Kojiro
背景/目的：乐伐替尼（LEN）已开发用于治疗不可切除的肝细胞癌（u-HCC）。我们的目的是阐明肝脏储备功能的相对变化后，早期LEN治疗的影响。材料/方法：2018年3月至2019年4月，入组了123例u-HCC患者（中位年龄71岁;男女比例95：28; Child-Pugh评分5：6：7 = 65：50：8;改良白蛋白-胆红素[mALBI] 1：2a：2 B：3 = 44：28：50：1，巴塞罗那临床肝癌A期：B：C = 1：49：73）。回顾性评价了开始LEN后2周和4周时肝脏储备功能的相对变化。结果：中位生存期为11.3个月。Child-Pugh评分从开始到开始LEN后4周下降（评分5：6：7：8：9：>= 10 = 65：50：8：0：0：0 vs. 50：39：22：8：0：4，p <0.001）。LEN开始时的ALBI评分与第2周和第4周的ALBI评分比较显示出显著的相对变化（2周时-2.36 +/-0.45至-2.20 +/-0.49，4周时-2.15 +/-0.50，p <0.001，Bonferroni方法），而2周和4周之间无显著性差异（p = 0.210，Bonferroni法）。按mALBI 1级、2a级和2b级或以上划分的患者ALBI评分的相对变化评估显示，无论级别如何，评分均显著下降（分别为-2.82 +/-0.17至-2.53 +/-0.34，p <0.001;-2.46 +/-0.10至-2.31 +/-0.33，p = 0.017;和-1.90 +/-0.26至-1.75 +/-0.42，p = 0.009）。结论：肝功能下降多见于早期（
Background/Aim: Lenvatinib (LEN) has been developed for the treatment of unresectable hepatocellular carcinoma (u-HCC). We aimed to elucidate the relative change in hepatic reserve function early following LEN treatment in affected patients. Materials/Methods: From March 2018 to April 2019, 123 u-HCC patients (median age 71 years; male:female ratio 95:28; Child-Pugh score 5:6:7 = 65:50:8; modified albumin-bilirubin [mALBI] grade 1:2a:2b:3 = 44:28:50:1, Barcelona Clinic Liver Cancer stage A:B:C = 1:49:73) were enrolled. Relative changes in hepatic reserve function at 2 and 4 weeks after starting LEN were retrospectively evaluated. Results: The median survival was 11.3 months. The Child-Pugh score declined from the start to 4 weeks after commencing LEN (score 5:6:7:8:9:>= 10 = 65:50:8:0:0:0 vs. 50:39:22:8:0:4, p < 0.001). A comparison among ALBI scores at the start of LEN and those at 2 and 4 weeks revealed significant relative changes (-2.36 +/- 0.45 to -2.20 +/- 0.49 at 2 weeks, -2.15 +/- 0.50 at 4 weeks, p < 0.001, Bonferroni method), while there was no significant difference between those at 2 and 4 weeks (p= 0.210, Bonferroni method). Assessments of relative changes of ALBI score in patients divided by mALBI grade 1, 2a, and 2b or more showed a significant decline in score regardless of grade (-2.82 +/- 0.17 to -2.53 +/- 0.34, p < 0.001; -2.46 +/- 0.10 to -2.31 +/- 0.33, p = 0.017; and -1.90 +/- 0.26 to -1.75 +/- 0.42, p= 0.009, respectively). Conclusion: Decline in hepatic function is common in the early stage (