The combination of sorafenib with transarterial chemoembolisation for hepatocellular carcinoma.

The combination of sorafenib with transarterial chemoembolisation for hepatocellular carcinoma.
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DOI:
10.1111/j.1365-2036.2011.04697.x
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发表时间:
2011-07
影响因子:
7.6
通讯作者:
Nelson DR
Nelson DR
中科院分区:
医学1区
文献类型:
--
作者:
Cabrera R;Pannu DS;Caridi J;Firpi RJ;Soldevila-Pico C;Morelli G;Clark V;Suman A;George TJ Jr;Nelson DR

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实践标准包括单独使用经动脉治疗多灶性肝细胞癌 (HCC),索拉非尼仅用于更晚期的 HCC,但索拉非尼和经动脉治疗组合可能会提供更好的疗效。评估同步索拉非尼和经动脉治疗 HCC 的安全性和有效性。连续的 HCC 病例接受索拉非尼和经动脉治疗,在经动脉治疗前 2 至 4 周接受索拉非尼。收集基线临床参数、不良事件 (AE) 和生存率。共有 47 名患者接受索拉非尼和经动脉治疗。大多数患者为男性(70%),患有 HCV(60%),中位年龄 60 岁,体能状态良好(0-1),稳定肝硬化(儿童:A 72%;B 28%),不可切除的转向(分期:B 81%;C 19%),中位 AFP 为 24 ng/mL。中位随访时间为 12 个月,索拉非尼治疗中位时间为 6 个月。 LC Bead TACE 的使用频率中值为 3。大多数患者 (89%) 出现 AE。最常见的不良事件是疲劳(51%)、手足皮肤反应(51%)和腹泻(43%)。 3 级和 4 级 AE 包括疲劳 (13%) 和手足皮肤反应 (26%)。大多数患者需要减少剂量(66%)。与经动脉治疗相关的主要 AE 是 TACE 后综合征 (23%)。 6个月时疾病控制率为68%。总体中位生存率为 18.5 个月(95% CI 16.1-20.9 个月)。同步索拉非尼和经动脉治疗总体上是安全的,没有意外的副作用,并且疗效令人鼓舞,值得进一步研究。
Standard of practice involves using transarterial therapy for multifocal hepatocellular carcinoma (HCC) alone and sorafenib only for more advanced HCC, but the sorafenib and transarterial therapy combination may provide greater efficacy. To evaluate the safety and efficacy of concurrent sorafenib and transarterial therapy in HCC. Consecutive cases of HCC were treated with sorafenib and transarterial therapy, receiving sorafenib 2 to 4 weeks before transarterial therapy. Baseline clinical parameters, adverse events (AEs) and survival were collected. A total of 47 patients received sorafenib and transarterial therapy. The majority of the patients were male (70%) with HCV (60%), median age of 60 years, good performance status (0–1), stable cirrhosis (Child: A 72%; B 28%), unresectable turnour (stage: B 81%; C 19%) and median AFP of 24 ng/mL. Median follow-up was 12 months and median time on sorafenib was 6 months. LC Bead TACE was used with a median frequency of 3. The majority of the patients (89%) experienced AEs. The most common AEs were fatigue (51%), hand-foot skin reaction (51%) and diarrhoea (43%). Grade 3 and 4 AEs included fatigue (13%) and hand-foot skin reaction (26%). Most patients required a dose reduction (66%). The main AE related to transarterial therapy was post-TACE syndrome (23%). The disease control rate was 68% at 6 months. Overall median survival rate was 18.5 months (95% CI 16.1–20.9 months). Concurrent sorafenib and transarterial therapy is overall safe with no unexpected side effects and encouraging efficacy that warrants further study.
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