Hepatocellular Carcinoma With Portal Vein Tumor Thrombus Treated With Transarterial Chemoembolization and Sorafenib vs. (125)Iodine Implantation.
Hepatocellular Carcinoma With Portal Vein Tumor Thrombus Treated With Transarterial Chemoembolization and Sorafenib vs. (125)Iodine Implantation.
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DOI：
10.3389/fonc.2021.806907
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发表时间：
2021
影响因子：
4.7
通讯作者：
Li HL
中科院分区：
文献类型：
--
作者：
Hu HT;Luo JP;Cao GS;Li Z;Jiang M;Guo CY;Yuan H;Yao QJ;Geng X;Park JH;Cheng HT;Jiang L;Ma JL;Zhao Y;Li HL
本研究探讨经动脉化疗栓塞术(TACE)联合CT引导下125I粒子植入治疗肝细胞癌(HCC)合并门静脉第一支癌栓(PVTT)的可行性、安全性和有效性。这项前瞻性、对照、多中心研究包括患有巴塞罗那临床肝癌C期疾病和门静脉右/或左门静脉曲张血栓的肝细胞癌患者。患者接受TACE和索拉非尼或TACE和CT引导下的125I粒子植入治疗，并定期评估临床反应和不良事件，如果临床状态下降、失去随访或死亡，则终止治疗。这项研究表明，中位总生存期(OS)在组间存在显著差异；因此，它被提前终止。这项研究共纳入123名患者，其中TACE-索拉非尼组52名患者，TACE-125I组71名患者，两组基线特征没有显著差异。中位OS8.3个月(95%CI：6.105~10.495)，TACE-125I组13.8个月(95%CI：9.519~18.081)。在IIa型与IIb型PVTT的亚组分析中，TACE-125I组IIa型患者的中位OS为17.5个月，IIb型患者为7.1个月。TACE-索拉非尼组IIa和IIb的中位OS分别为9.3个月和4.0个月。单因素和多因素分析证实，PVTT类型和治疗策略是影响OS的显著独立因素。肝内病变的客观有效率(ORR)和门静脉血栓形成时间(PVTT)组间差异有统计学意义。两组中的大多数患者都经历了与TACE相关的轻微不良事件。TACE-索拉非尼组索拉非尼相关不良事件或毒性反应的总发生率为90.4%。TACE-125I组气胸发生率为7.04%，轻度肝被膜下出血发生率为9.86%。这项研究表明，TACE-125I治疗显著提高了肝癌和II型PVTT患者的存活率，特别是IIa亚型患者的存活率，不良反应最小。中国临床试验数据库，识别号：CHICCTR-ONN-16007929。
This study investigated the feasibility, safety, and efficacy of transarterial chemoembolization (TACE) combined with CT-guided 125iodine seed implantation for treatment of hepatocellular carcinoma (HCC) with first-branch portal vein tumor thrombosis (PVTT). This prospective, controlled, multicenter study included HCC patients with Barcelona Clinic Liver Cancer stage C disease and PVTT in the right and/or left portal veins. Patients were treated with either TACE and sorafenib or TACE and CT-guided 125iodine seed implantation and regularly evaluated for clinical response and adverse events, with treatment termination resulting from declining clinical status, loss to follow-up, or death. This study demonstrated a significant between-group difference in median overall survival (OS); therefore, it was terminated early. A total of 123 patients were included in this study, with 52 patients in the TACE-sorafenib group and 71 patients in the TACE-125iodine group, without significant differences in baseline characteristics between groups. The median OS was 8.3 months (95% CI: 6.105–10.495) in the TACE-sorafenib group and 13.8 months (95% CI: 9.519–18.081) in the TACE-125iodine group. In a subgroup analysis of type IIa versus type IIb PVTT, the median OS was 17.5 months for type IIa and 7.1 months for IIb in the TACE-125iodine group. The median OS was 9.3 months for IIa and 4.0 months for IIb in the TACE-sorafenib group. Univariate and multivariate analyses confirmed that the PVTT type and treatment strategy were significant independent factors affecting OS. The objective response rates (ORR) for intrahepatic lesions and PVTT showed significant differences between groups. Most patients in both groups experienced minor adverse events related to TACE. The overall incidence of sorafenib-related adverse events or toxic effects was 90.4% in TACE-sorafenib group. In the TACE-125iodine group, the incidence of pneumothorax and minor hepatic subcapsular hemorrhage were 7.04% and 9.86%, respectively. This study showed that TACE-125iodine treatment significantly enhanced survival of patients with HCC and type II PVTT, especially subtype IIa, with minimal adverse events. Chinese Clinical Trials Database, identifier ChiCTR-ONN-16007929.
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DOI：
10.1007/s00432-013-1568-0
发表时间：
2014-02-01
影响因子：
3.6
作者：
Yang, MinJie;Fang, ZhuTing;Liu, QingXin
通讯作者：
Liu, QingXin
影响因子：
4.3
作者：
Song, Do Seon;Bae, Si Hyun;Yoon, Seung Kew
通讯作者：
Yoon, Seung Kew
影响因子：
3
作者：
Choi, Jong Hwan;Chung, Woo Jin;Cho, Sung Bum
通讯作者：
Cho, Sung Bum
影响因子：
5.2
作者：
Rim CH;Park S;Shin IS;Yoon WS
通讯作者：
Yoon WS
索拉非尼对亚太地区晚期肝细胞癌患者的疗效和安全性：一项 III 期随机、双盲、安慰剂对照试验
影响因子：
51.1
作者：
Cheng, Ann-Lii;Kang, Yoon-Koo;Guan, Zhongzhen
通讯作者：
Guan, Zhongzhen