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Comparison of Sorafenib versus Hepatic Arterial Infusion Chemotherapy-Based Treatment for Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis

Gut and Liver 2021년 15권 2호 p.284 ~ 294
안영은, 서상준, 임형준, 서연석, Yoon Eileen L., 김태형, 이영선, 임선영, 김해림, 강성희, 정영걸, 김지훈, 연종은, 엄순호, 변관수,
소속 상세정보
안영은 ( Ahn Young-Eun ) - Korea University College of Medicine Department of Internal Medicine
서상준 ( Suh Sang-June ) - Korea University College of Medicine Department of Internal Medicine
임형준 ( Yim Hyung-Joon ) - Korea University College of Medicine Department of Internal Medicine
서연석 ( Seo Yeon-Seok ) - Korea University College of Medicine Department of Internal Medicine
 ( Yoon Eileen L. ) - Inje University College of Medicine Department of Internal Medicine
김태형 ( Kim Tae-Hyung ) - Korea University College of Medicine Department of Internal Medicine
이영선 ( Lee Young-Sun ) - Korea University College of Medicine Department of Internal Medicine
임선영 ( Yim Sun-Young ) - Korea University College of Medicine Department of Internal Medicine
김해림 ( Kim Hae-Rim ) - Korea University College of Medicine Department of Internal Medicine
강성희 ( Kang Seong-Hee ) - Yonsei University Wonju College of Medicine Department of Internal Medicine
정영걸 ( Jung Young-Kul ) - Korea University College of Medicine Department of Internal Medicine
김지훈 ( Kim Ji-Hoon ) - Korea University College of Medicine Department of Internal Medicine
연종은 ( Yeon Jong-Eun ) - Korea University College of Medicine Department of Internal Medicine
엄순호 ( Um Soon-Ho ) - Korea University College of Medicine Department of Internal Medicine
변관수 ( Byun Kwan-Soo ) - Korea University College of Medicine Department of Internal Medicine

Abstract


Background/Aims: Sorafenib is the first approved systemic treatment for advanced hepatocellular carcinoma (HCC). However, its clinical utility is limited, especially in Asian countries. Several reports have suggested the survival benefits of hepatic arterial infusion chemotherapy (HAIC) for advanced HCC with main portal vein tumor thrombosis (PVTT). This study aimed to compare the efficacy of sorafenib-based therapy with that of HAIC-based therapy for advanced HCC with main PVTT.

Methods: Advanced HCC patients with main PVTT treated with sorafenib or HAIC between 2008 and 2016 at Korea University Medical Center were included. We evaluated overall survival (OS), time-to-progression (TTP), and the disease control rate (DCR).

Results: Seventy-three patients were treated with sorafenib (n=35) or HAIC (n=38). Baseline characteristics were not significantly different between groups, except the presence of solid organ metastasis (46% vs 5.3%, p<0.001). The median OS time was not significantly different between the groups (6.4 months vs 10.0 months, p=0.139). TTP was longer in the HAIC group than in the sorafenib group (2.1 months vs 6.2 months, p=0.006). The DCR was also better in the HAIC group than in the sorafenib group (37% vs 76%, p=0.001). Subgroup analysis, which excluded patients with extrahepatic solid organ metastasis, showed the same trends for the median OS time (8.8 months vs 11.1 months, p=0.097), TTP (1.9 months vs 6.0 months, p<0.001), and DCR (53% vs 81%, p=0.030).

Conclusions: HAIC-based therapy may be an alternative to sorafenib for advanced HCC with main PVTT by providing longer TTP and a better DCR.

키워드

Carcinoma, hepatocellular; Portal vein thrombosis; Sorafenib; Hepatic artery; Chemotherapy

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