Sorafenib continuation or discontinuation in patients with unresectable hepatocellular carcinoma after a complete response.
Sorafenib continuation or discontinuation in patients with unresectable hepatocellular carcinoma after a complete response.
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不可切除的肝细胞癌患者在完全缓解后继续或停止索拉非尼
DOI：
10.18632/oncotarget.4076
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发表时间：
2015-09-15
期刊：
影响因子：
--
通讯作者：
Li J
中科院分区：
文献类型：
--
作者：
Zhang Y;Fan W;Zhu K;Lu L;Fu S;Huang J;Wang Y;Yang J;Huang Y;Yao W;Li J
目的评价完全缓解(CR)后局部区域治疗(LRT)不能切除的肝癌患者继续应用索拉非尼的疗效，并观察停药后索拉非尼的不良反应。方法回顾分析2008年4月至2012年5月956例不能手术切除的肝细胞癌患者采用肝动脉化疗栓塞术、射频消融术联合索拉非尼治疗的临床资料。在这些患者中，有157名CR患者入选：其中102人继续接受索拉非尼治疗(试验组)，另外55人停止接受索拉非尼治疗(对照组)。结果试验组和对照组的中位无复发生存期(RFS)、完全缓解后总生存期(POS)和总生存期(OS)分别为11个月(95%CI：6.1，15.9)、25个月(95%CI：20.7，29.3)和33个月(95%CI：29.2，36.8)和12个月(95%CI：10.4，13.6)、28个月(95%CI：24.2，31.8)和34个月(95%CI：30.8，37.2)。RFS、POS和OS组间差异无统计学意义(P分别为0.768、0.797和0.730)。停药后与索拉非尼相关的不良反应消失，生活质量评分提高。结论获得CR的不能切除的肝细胞癌患者在RFS、POS或OS方面不能从继续使用索拉非尼获益。索拉非尼的不良反应是可逆的，停用索拉非尼可能会改善获得CR的患者的生活质量。
Aims To assess the efficacy of continued administration of sorafenib for patients with unresectable hepatocellular carcinoma (HCC) treated with local regional therapy (LRT) after a complete response (CR), also, the adverse events of sorafenib after discontinuation of administration were observed. Methods Between April 2008 and May 2012, 956 consecutive patients with unresectable HCC treated with LRT (transarterial chemoembolization, radiofrequency ablation) combined with sorafenib were retrospectively investigated. Of these, 157 patients with a CR were enrolled: 102 of them continued to receive sorafenib (test group) and the other 55 stopped receiving sorafenib (control group). Results The median recurrence-free survival (RFS), post-complete response overall survival (pOS) and overall survival (OS) in the test and control groups were 11 months (95% CI: 6.1, 15.9), 25 months (95% CI: 20.7, 29.3) and 33 months (95% CI: 29.2, 36.8) and 12 months (95% CI: 10.4, 13.6), 28 months (95% CI 24.2, 31.8) and 34 months (95% CI: 30.8, 37.2) respectively. The differences in RFS, pOS and OS between the groups were not significant (P = 0.768, 0.797 and 0.730, respectively). The adverse events related to sorafenib resolved after discontinuation of administration and the quality of life (QoL) scores improved. Conclusions Patients with unresectable HCC who achieved a CR did not benefit from continued sorafenib in terms of RFS, pOS or OS. The adverse events of sorafenib were reversible, and discontinuation of sorafenib may improve the QoL of patients who have achieved a CR.