Assessment of lenvatinib treatment for unresectable hepatocellular carcinoma with liver cirrhosis

Assessment of lenvatinib treatment for unresectable hepatocellular carcinoma with liver cirrhosis
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DOI：
10.1016/j.hpb.2020.03.002
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发表时间：
2020-10-01
期刊：
HPB
影响因子：
2.9
通讯作者：
Fukumoto, Takumi
Fukumoto, Takumi
中科院分区：
医学3区
文献类型：
--
作者：
Komatsu, Shohei;Yano, Yoshihiko;Fukumoto, Takumi

文献摘要

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背景：本研究旨在评估接受lenvatinib治疗不可切除肝细胞癌（HCC）患者的临床特征。方法：对51例连续患者的临床特点、不良事件及放射学反应进行评价。结果：37例Child-Pugh A级（CPA）肝功能，14例Child-Pugh B级（CPB）肝功能。CPA组和CPB组的总有效率分别为42.9%和25.0%，疾病控制率分别为82.9%和83.3%，差异无统计学意义（p = 0.2621和0.9697）。除肝昏迷外，CPA组与CPB组的不良事件发生率无显著差异。CPA组与CPB组在第1个月、1-2个月、2-3个月的相对剂量强度比较，差异均无统计学意义（p = 0.2368、0.9368、0.9293）。结论：CPA组和CPB组之间的可比结果表明，lenvatinib治疗肝功能受损患者，至少在急性期是可接受的。通过仔细的随访，即使对肝功能受损的患者，剂量也可以相对加大，这可能有助于提供可比的治疗。
Background: The present study aimed to assess the clinical features of patients who received lenvatinib treatment for unresectable hepatocellular carcinoma (HCC).Methods: The clinical characteristics, adverse events, and radiological responses were evaluated for 51 consecutive patients.Results: Of the study subjects, 37 patients had Child-Pugh class A (CPA) liver function, and 14 patients had Child-Pugh class B (CPB) liver function. The overall response rates in the CPA and CPB groups were 42.9% and 25.0%, respectively, and disease control rates were 82.9% and 83.3%, respectively, without significant difference (p = 0.2621 and 0.9697). There was no significant difference between CPA and CPB groups regarding the incidence of adverse events, except for hepatic coma. No significant difference was observed in the relative dose intensity between the CPA and CPB groups, for the first month, 1-2 months, or 2-3 months (p = 0.2368, 0.9368, and 0.9293).Conclusion: The comparable outcomes between the CPA and CPB groups suggest the acceptability of lenvatinib treatment in patients with impaired liver function, at least in the acute phase. With careful follow-up, the dose can be relatively intensified, even in patients with impaired liver function and this may contribute to offering comparable treatment.