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Cited 59 time in webofscience Cited 63 time in scopus
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Randomized, prospective, comparative study on the effects and safety of sorafenib vs. hepatic arterial infusion chemotherapy in patients with advanced hepatocellular carcinoma with portal vein tumor thrombosis

Authors
Choi, Jong HwanChung, Woo JinBae, Si HyunSong, Do SeonSong, Myeong JunKim, Young SeokYim, Hyung JoonJung, Young KulSuh, Sang JunPark, Jun YongKim, Do YoungKim, Seung UpCho, Sung Bum
Issue Date
Sep-2018
Publisher
SPRINGER
Keywords
Hepatocellular carcinoma; Portal vein tumor thrombosis; Sorafenib; Hepatic arterial infusion chemotherapy; Prognosis
Citation
CANCER CHEMOTHERAPY AND PHARMACOLOGY, v.82, no.3, pp.469 - 478
Indexed
SCIE
SCOPUS
Journal Title
CANCER CHEMOTHERAPY AND PHARMACOLOGY
Volume
82
Number
3
Start Page
469
End Page
478
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/3217
DOI
10.1007/s00280-018-3638-0
ISSN
0344-5704
Abstract
Treatment responses of advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) remain unacceptably low and treatment modalities are limited. We compared the efficacy and safety of sorafenib and hepatic arterial infusion chemotherapy (HAIC). In this randomized, prospective, comparative study, data on 58 patients with advanced HCC with PVTT, with Child-Turcotte-Pugh (CTP) scores of 5-7, were collected from six university hospitals between January 2013 and October 2015. Twenty-nine patients were treated with sorafenib and twenty-nine with HAIC. The median overall survival (OS) and time to progression (TTP) were significantly longer in the HAIC group than in the sorafenib group (14.9 vs.7.2 months, p = 0.012 and 4.4 vs. 2.7 months, p = 0.010). The objective response (OR) rates were 27.6 and 3.4% in the HAIC and sorafenib groups, respectively (p = 0.001). In univariate analysis, sex, main portal vein invasion and treatment modality were significant prognostic factors of OS (p = 0.044, 0.040, 0.015), whereas cause of HCC, tumor number, tumor location and treatment modality were significant prognostic factors of TTP (p = 0.040, 0.002, 0.034, 0.014). In multivariate analysis, sex and treatment modality were significant prognostic factors of OS (p = 0.008, 0.005), whereas cause of HCC, tumor number, tumor location and treatment modality were significant prognostic factors of TTP (p = 0.038, 0.038, 0.015, 0.011). Major complications included hyperbilirubinemia (44.8%), AST elevation (34.5%), ascites (13.8%) and catheter-related complications (3.4%) in the HAIC group and hyperbilirubinemia (34.5%), hand-foot syndrome (31.0%) and AST elevation (27.6%) in the sorafenib group. For managing advanced HCC with PVTT, HAIC may be a valuable treatment modality.
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Ansan Hospital (Department of Gastroenterology and Hepatology, Ansan Hospital)
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