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Hepatic Arterial Infusion of Oxaliplatin plus Fluorouracil/Leucovorin versus Sorafenib for Advanced Hepatocellular Carcinoma
Journal of Hepatology ( IF 26.8 ) Pub Date : 2018-07-01 , DOI: 10.1016/j.jhep.2018.02.008
Ning Lyu , Yanan Kong , Luwen Mu , Youen Lin , Jibin Li , Yaru Liu , Zhenfeng Zhang , Lie Zheng , Haijing Deng , Shaolong Li , Qiankun Xie , Rongping Guo , Ming Shi , Li Xu , Xiuyu Cai , Peihong Wu , Ming Zhao

BACKGROUND & AIMS To compare the overall survival (OS) and disease progression free survival (PFS) in patients with advanced hepatocellular carcinoma (Ad-HCC) who are undergoing hepatic arterial infusion (HAI) of oxaliplatin, fluorouracil/leucovorin (FOLFOX) treatment vs. sorafenib. METHODS This retrospective study was approved by the ethical review committee, and informed consent was obtained from all patients before treatment. HAI of FOLFOX (HAIF) was recommended as an alternative treatment option for patients who refused sorafenib. Of the 412 patients with Ad-HCC (376 men and 36 women) between Jan 2012 to Dec 2015, 232 patients were treated with sorafenib; 180 patients were given HAIF therapy. The median age was 51 years (range, 16-82 years). Propensity-score matched estimates were used to reduce bias when evaluating survival. Survival curves were calculated by performing the Kaplan-Meier method and compared by using the log-rank test and Cox regression models. RESULTS The median PFS and OS in the HAIF group were significantly longer than those in the sorafenib group (PFS 7.1 vs. 3.3 months [RECIST]/7.4 vs. 3.6 months [mRECIST], respectively; OS 14.5 vs. 7.0 months; p <0.001 for each). In the propensity-score matched cohorts (147 pairs), both PFS and OS in the HAIF group were longer than those in the sorafenib group (p <0.001). At multivariate analysis, HAIF treatment was an independent factor for PFS (hazard ratio [HR] 0.389 [RECIST]/0.402 [mRECIST]; p <0.001 for each) and OS (HR 0.129; p <0.001). CONCLUSION HAIF therapy may improve survival compared to sorafenib in patients with Ad-HCC. A prospective randomized trial is ongoing to confirm this finding. LAY SUMMARY We compared the hepatic arterial infusion of FOLFOX (a combination chemotherapy) with sorafenib (a tyrosine kinase inhibitor) in patients with advanced hepatocellular carcinoma, retrospectively. It was found that hepatic arterial infusion of FOLFOX therapy may improve both progression free and overall survival in patients with advanced hepatocellular carcinoma.

中文翻译:

奥沙利铂加氟尿嘧啶/亚叶酸与索拉非尼治疗晚期肝细胞癌的肝动脉输注

背景和目的 比较接受奥沙利铂、氟尿嘧啶/亚叶酸 (FOLFOX) 治疗与肝动脉灌注 (HAI) 的晚期肝细胞癌 (Ad-HCC) 患者的总生存期 (OS) 和无疾病进展生存期 (PFS)。 . 索拉非尼。方法本回顾性研究经伦理审查委员会批准,治疗前获得所有患者的知情同意。FOLFOX 的 HAI (HAIF) 被推荐作为拒绝索拉非尼患者的替代治疗选择。在 2012 年 1 月至 2015 年 12 月期间的 412 名 Ad-HCC 患者(376 名男性和 36 名女性)中,232 名患者接受了索拉非尼治疗;180 名患者接受了 HAIF 治疗。中位年龄为 51 岁(范围为 16-82 岁)。在评估生存时,倾向评分匹配估计值用于减少偏差。通过执行 Kaplan-Meier 方法计算生存曲线,并通过使用对数秩检验和 Cox 回归模型进行比较。结果 HAIF 组的中位 PFS 和 OS 显着长于索拉非尼组(PFS 分别为 7.1 与 3.3 个月 [RECIST]/7.4 与 3.6 个月 [mRECIST];OS 14.5 与 7.0 个月;p <每个 0.001)。在倾向评分匹配的队列(147 对)中,HAIF 组的 PFS 和 OS 均长于索拉非尼组(p <0.001)。在多变量分析中,HAIF 治疗是 PFS(风险比 [HR] 0.389 [RECIST]/0.402 [mRECIST];每个 p <0.001)和 OS(HR 0.129;p <0.001)的独立因素。结论 与索拉非尼相比,HAIF 治疗可以提高 Ad-HCC 患者的生存率。一项前瞻性随机试验正在进行以证实这一发现。概述 我们回顾性地比较了 FOLFOX(一种联合化疗)与索拉非尼(一种酪氨酸激酶抑制剂)在晚期肝细胞癌患者中的肝动脉输注。研究发现,肝动脉输注 FOLFOX 治疗可改善晚期肝细胞癌患者的无进展生存期和总生存期。
更新日期:2018-07-01
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