Clinical parameters predictive of outcomes in sorafenib-treated patients with advanced hepatocellular carcinoma
Clinical parameters predictive of outcomes in sorafenib-treated patients with advanced hepatocellular carcinoma
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DOI：
10.1111/liv.12168
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发表时间：
2013-07-01
影响因子：
6.7
通讯作者：
Yoo, Byung Chul
中科院分区：
文献类型：
--
作者：
Cho, Ju-Yeon;Paik, Yong-Han;Yoo, Byung Chul
背景索拉非尼是一种口服活性多激酶抑制剂，被批准用于治疗晚期肝细胞癌（HCC）。然而，可预测索拉非尼治疗的晚期 HCC 患者治疗结果的临床参数仍不清楚。方法回顾性分析2007年1月至2011年12月期间以索拉非尼为初始治疗方式的99例晚期（BCLC C）HCC患者。总生存期是分析的主要终点。分析了各种临床参数，包括肿瘤分期和索拉非尼的不良反应。进行单变量和多变量分析以确定预测索拉非尼效果的临床参数。结果本研究共纳入男性86例，女性13例，中位年龄53岁。中位总生存期为 91 天。 69 名患者患有 Child-Pugh A 级肝硬化，30 名患者患有 Child-Pugh B 级肝硬化。乙型肝炎病毒是肝癌的主要原因（75.8%）。注意到的不良反应包括手足综合症、腹泻、疲劳、腹痛、恶心和口腔炎。在多变量分析中，手足综合征和腹泻的存在以及门静脉血栓形成和淋巴结转移的不存在预示着更好的总生存期。排除淋巴结转移的情况，相同的参数与较长的放射学进展时间相关。结论 接受索拉非尼治疗后出现手足综合征和腹泻的晚期 HCC 患者比没有这些副作用的患者表现出更好的总生存期。这些副作用可用作预测 HCC 患者索拉非尼反应的临床参数。
Background Sorafenib is an orally active multikinase inhibitor approved for the treatment of advanced hepatocellular carcinoma (HCC). However, clinical parameters that may predict the treatment outcomes in sorafenib-treated advanced HCC patients remains unknown. Methods A total of 99 advanced (BCLC C) HCC patients treated with sorafenib as an initial treatment modality from January 2007 to December 2011 were retrospectively reviewed. Overall survival was the primary endpoint for the analysis. Various clinical parameters including tumour stage and adverse effects to sorafenib were analysed. Univariate and multivariate analysis were carried out to identify clinical parameters predictive of the effect of sorafenib. Results There were 86 males and 13 females included in this study, with a median age of 53years. The median overall survival was 91days. Sixty-nine patients had Child-Pugh class A cirrhosis and 30 patients had Child-Pugh class B cirrhosis. Hepatitis B virus was the predominant cause of HCC (75.8%). Noted adverse effects were hand-foot syndrome, diarrhoea, fatigue, abdominal pain, nausea and stomatitis. The presence of hand-foot syndrome and diarrhoea and the absence of portal vein thrombosis and lymph node metastasis predicted a better overall survival in the multivariate analysis. Excluding the absence of lymph node metastasis, the same parameters were associated with a longer radiological time to progression. Conclusion Advanced HCC patients treated with sorafenib who experienced hand-foot syndrome and diarrhoea showed better overall survival than patients without these side effects. These side effects may be used as clinical parameters predictive of sorafenib response in patients with HCC.