a comparative study of sorafenib and metronomic chemotherapy for barcelona clinic liver cancer-stage c hepatocellular carcinoma with poor liver function

estudio comparativo de sorafenib y quimioterapia metronómica para el carcinoma hepatocelular en estadio c de la barcelona clinic liver cancer con función hepática deficiente

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ID: 199637
2017
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Abstract
Background/Aims Metronomic chemotherapy (MET) is frequently administered in comparatively low doses as a continuous chemotherapeutic agent. The aim of this study was to evaluate the feasibility and overall survival (OS) of MET compared to sorafenib for advanced hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT). Methods A total of 54 patients with advanced HCC and PVTT who had undergone MET were analyzed between 2005 and 2013. A total of 53 patients who had undergone sorafenib therapy were analyzed as the control group. The primary endpoint of this study was OS. Results The median number of MET cycles was two (1-15). The OS values for the MET group and sorafenib group were 158 days (132-184) and 117 days (92-142), respectively (P=0.029). The Cox proportional-hazard model showed that a higher risk of death was correlated with higher serum alpha fetoprotein level (≥400 mg/dL, hazard ratio [HR]=1.680, P=0.014) and Child-Pugh class B (HR=1.856, P=0.008). Conclusions MET was associated with more favorable outcomes in terms of overall survival than was sorafenib in patients with advanced HCC with PVTT, especially in patients with poor liver function. Therefore, MET can be considered as a treatment option in patients with advanced HCC with PVTT and poor liver function.
Antecedentes/Objetivos La quimioterapia metronómica (MET) se administra con frecuencia en dosis comparativamente bajas como agente quimioterápico continuo. El objetivo de este estudio fue evaluar la viabilidad y la supervivencia global (SG) de la MET en comparación con el sorafenib en pacientes con carcinoma hepatocelular (CHC) avanzado y trombosis tumoral de la vena porta (TTVP). Métodos Se analizó a un total de 54 pacientes con CHC avanzado y TTVP que habían recibido MET entre 2005 y 2013. Se analizó a un total de 53 pacientes que habían recibido tratamiento con sorafenib como grupo control. El criterio de valoración principal de este estudio fue la SG. Resultados La mediana del número de ciclos de MET fue de dos (1-15). Los valores de SG para el grupo de MET y el grupo de sorafenib fueron de 158 días (132-184) y 117 días (92-142), respectivamente (P=0,029). El modelo de riesgos proporcionales de Cox mostró que un mayor riesgo de muerte se correlacionó con un nivel sérico más elevado de alfafetoproteína (≥400 mg/dL, hazard ratio [HR]=1,680, P=0,014) y la clase B de Child-Pugh (HR=1,856, P=0,008). Conclusiones La MET se asoció con resultados más favorables en términos de supervivencia global que el sorafenib en pacientes con CHC avanzado y TTVP, especialmente en aquellos con función hepática deficiente. Por lo tanto, la MET puede considerarse una opción terapéutica en pacientes con CHC avanzado con TTVP y función hepática deficiente.
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yang2017clinicala Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;Hyun Yang;Hyun Young Woo;Soon Kyu Lee;Ji Won Han;Bohyun Jang;Hee Chul Nam;Hae Lim Lee;Sung Won Lee;Do Seon Song;Myeong Jun Song;Jung Suk Oh;Ho Jong Chun;Jeong Won Jang;Angelo Lozada;Si Hyun Bae;Jong Young Choi;Seung Kew Yoon
Journal american journal of clinical oncology
Year 2017
DOI
10.3350/cmh.2016.0071
URL
http://e-cmh.org/upload/pdf/cmh-2016-0071.pdf
Keywords
sorafenib carcinoma administration Gastroenterology

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