Cargando…

Evaluation of dose-efficacy of sorafenib and effect of transarterial chemoembolization in hepatocellular carcinoma patients: a retrospective study

BACKGROUND: Transarterial chemoembolization (TACE) and sorafenib are the therapeutic standard for intermediate and advanced stage hepatocellular carcinoma (HCC) patients respectively. High costs with adverse events (AE) of sorafenib might limit sorafenib dosage, further affecting therapeutic respons...

Descripción completa

Detalles Bibliográficos
Autores principales: Hsiao, Wang-De, Peng, Cheng-Yuan, Chuang, Po-Heng, Lai, Hsueh-Chou, Cheng, Ken-Sheng, Chou, Jen-Wei, Chen, Yang-Yuan, Yu, Cheng-Ju, Feng, Chun-Lung, Su, Wen-Pang, Chen, Sheng-Hung, Kao, Jung-Ta
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4847248/
https://www.ncbi.nlm.nih.gov/pubmed/27117280
http://dx.doi.org/10.1186/s12876-016-0464-x
_version_ 1782429175882186752
author Hsiao, Wang-De
Peng, Cheng-Yuan
Chuang, Po-Heng
Lai, Hsueh-Chou
Cheng, Ken-Sheng
Chou, Jen-Wei
Chen, Yang-Yuan
Yu, Cheng-Ju
Feng, Chun-Lung
Su, Wen-Pang
Chen, Sheng-Hung
Kao, Jung-Ta
author_facet Hsiao, Wang-De
Peng, Cheng-Yuan
Chuang, Po-Heng
Lai, Hsueh-Chou
Cheng, Ken-Sheng
Chou, Jen-Wei
Chen, Yang-Yuan
Yu, Cheng-Ju
Feng, Chun-Lung
Su, Wen-Pang
Chen, Sheng-Hung
Kao, Jung-Ta
author_sort Hsiao, Wang-De
collection PubMed
description BACKGROUND: Transarterial chemoembolization (TACE) and sorafenib are the therapeutic standard for intermediate and advanced stage hepatocellular carcinoma (HCC) patients respectively. High costs with adverse events (AE) of sorafenib might limit sorafenib dosage, further affecting therapeutic response. To attain greatest benefit, we evaluated the efficacy of different doses and effect of TACE during and after sorafenib discontinuation in patients representing Child-Pugh Classification Class A with venous or extra-hepatic invasion. METHODS: A total 156 patients met the criteria and were divided into Groups I (n = 52) accepting 800 mg/day; II (n = 58) accepting 800 mg/day and reduced to 400 mg/day owing to AE; and III (n = 46) accepting 400 mg/day. TACE was performed during and after sorafenib discontinuation and therapeutic response bimonthly to four-monthly was rated thereafter. RESULTS: Median duration of sorafenib treatment and patients’ survival were 4.00 ± 0.45 and 7.50 ± 1.44 months in all cases; 2.50 ± 0.90 and 5.00 ± 1.10 months in Group I; 5.50 ± 1.27 and 16.50 ± 1.86 months in Group II; 4.00 ± 0.94 and 6.50 ± 2.49 months in Group III. Group II presented the best response and survival benefit (p = 0.010 and p = 0.011 respectively). Child-Pugh Classification score 5 (Hazard Ratio = 0.492, p = 0.049), absent AE (3.423, p = 0.015), tumor numbers ≤ 3 (0.313, p = 0.009), sorafenib duration ≤ 1 cycle (3.694, p = 0.004), and absent TACE (3.197, p = 0.008) significantly correlated with patient survival. TACE benefit appeared in separate and total cases during (p = 0.002, p = 0.595, p = 0.074, p = 0.002 respectively) and after discontinuation of sorafenib administration (p = 0.001, p = 0.034, p = 0.647, p = 0.001 respectively). CONCLUSIONS: Low-dosage sorafenib not only appeared tolerable and lowered economic pressure but also provided satisfactory results. TACE benefited patient’s survival during and after sorafenib discontinuation.
format Online
Article
Text
id pubmed-4847248
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-48472482016-04-28 Evaluation of dose-efficacy of sorafenib and effect of transarterial chemoembolization in hepatocellular carcinoma patients: a retrospective study Hsiao, Wang-De Peng, Cheng-Yuan Chuang, Po-Heng Lai, Hsueh-Chou Cheng, Ken-Sheng Chou, Jen-Wei Chen, Yang-Yuan Yu, Cheng-Ju Feng, Chun-Lung Su, Wen-Pang Chen, Sheng-Hung Kao, Jung-Ta BMC Gastroenterol Research Article BACKGROUND: Transarterial chemoembolization (TACE) and sorafenib are the therapeutic standard for intermediate and advanced stage hepatocellular carcinoma (HCC) patients respectively. High costs with adverse events (AE) of sorafenib might limit sorafenib dosage, further affecting therapeutic response. To attain greatest benefit, we evaluated the efficacy of different doses and effect of TACE during and after sorafenib discontinuation in patients representing Child-Pugh Classification Class A with venous or extra-hepatic invasion. METHODS: A total 156 patients met the criteria and were divided into Groups I (n = 52) accepting 800 mg/day; II (n = 58) accepting 800 mg/day and reduced to 400 mg/day owing to AE; and III (n = 46) accepting 400 mg/day. TACE was performed during and after sorafenib discontinuation and therapeutic response bimonthly to four-monthly was rated thereafter. RESULTS: Median duration of sorafenib treatment and patients’ survival were 4.00 ± 0.45 and 7.50 ± 1.44 months in all cases; 2.50 ± 0.90 and 5.00 ± 1.10 months in Group I; 5.50 ± 1.27 and 16.50 ± 1.86 months in Group II; 4.00 ± 0.94 and 6.50 ± 2.49 months in Group III. Group II presented the best response and survival benefit (p = 0.010 and p = 0.011 respectively). Child-Pugh Classification score 5 (Hazard Ratio = 0.492, p = 0.049), absent AE (3.423, p = 0.015), tumor numbers ≤ 3 (0.313, p = 0.009), sorafenib duration ≤ 1 cycle (3.694, p = 0.004), and absent TACE (3.197, p = 0.008) significantly correlated with patient survival. TACE benefit appeared in separate and total cases during (p = 0.002, p = 0.595, p = 0.074, p = 0.002 respectively) and after discontinuation of sorafenib administration (p = 0.001, p = 0.034, p = 0.647, p = 0.001 respectively). CONCLUSIONS: Low-dosage sorafenib not only appeared tolerable and lowered economic pressure but also provided satisfactory results. TACE benefited patient’s survival during and after sorafenib discontinuation. BioMed Central 2016-04-27 /pmc/articles/PMC4847248/ /pubmed/27117280 http://dx.doi.org/10.1186/s12876-016-0464-x Text en © Hsiao et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Hsiao, Wang-De
Peng, Cheng-Yuan
Chuang, Po-Heng
Lai, Hsueh-Chou
Cheng, Ken-Sheng
Chou, Jen-Wei
Chen, Yang-Yuan
Yu, Cheng-Ju
Feng, Chun-Lung
Su, Wen-Pang
Chen, Sheng-Hung
Kao, Jung-Ta
Evaluation of dose-efficacy of sorafenib and effect of transarterial chemoembolization in hepatocellular carcinoma patients: a retrospective study
title Evaluation of dose-efficacy of sorafenib and effect of transarterial chemoembolization in hepatocellular carcinoma patients: a retrospective study
title_full Evaluation of dose-efficacy of sorafenib and effect of transarterial chemoembolization in hepatocellular carcinoma patients: a retrospective study
title_fullStr Evaluation of dose-efficacy of sorafenib and effect of transarterial chemoembolization in hepatocellular carcinoma patients: a retrospective study
title_full_unstemmed Evaluation of dose-efficacy of sorafenib and effect of transarterial chemoembolization in hepatocellular carcinoma patients: a retrospective study
title_short Evaluation of dose-efficacy of sorafenib and effect of transarterial chemoembolization in hepatocellular carcinoma patients: a retrospective study
title_sort evaluation of dose-efficacy of sorafenib and effect of transarterial chemoembolization in hepatocellular carcinoma patients: a retrospective study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4847248/
https://www.ncbi.nlm.nih.gov/pubmed/27117280
http://dx.doi.org/10.1186/s12876-016-0464-x
work_keys_str_mv AT hsiaowangde evaluationofdoseefficacyofsorafenibandeffectoftransarterialchemoembolizationinhepatocellularcarcinomapatientsaretrospectivestudy
AT pengchengyuan evaluationofdoseefficacyofsorafenibandeffectoftransarterialchemoembolizationinhepatocellularcarcinomapatientsaretrospectivestudy
AT chuangpoheng evaluationofdoseefficacyofsorafenibandeffectoftransarterialchemoembolizationinhepatocellularcarcinomapatientsaretrospectivestudy
AT laihsuehchou evaluationofdoseefficacyofsorafenibandeffectoftransarterialchemoembolizationinhepatocellularcarcinomapatientsaretrospectivestudy
AT chengkensheng evaluationofdoseefficacyofsorafenibandeffectoftransarterialchemoembolizationinhepatocellularcarcinomapatientsaretrospectivestudy
AT choujenwei evaluationofdoseefficacyofsorafenibandeffectoftransarterialchemoembolizationinhepatocellularcarcinomapatientsaretrospectivestudy
AT chenyangyuan evaluationofdoseefficacyofsorafenibandeffectoftransarterialchemoembolizationinhepatocellularcarcinomapatientsaretrospectivestudy
AT yuchengju evaluationofdoseefficacyofsorafenibandeffectoftransarterialchemoembolizationinhepatocellularcarcinomapatientsaretrospectivestudy
AT fengchunlung evaluationofdoseefficacyofsorafenibandeffectoftransarterialchemoembolizationinhepatocellularcarcinomapatientsaretrospectivestudy
AT suwenpang evaluationofdoseefficacyofsorafenibandeffectoftransarterialchemoembolizationinhepatocellularcarcinomapatientsaretrospectivestudy
AT chenshenghung evaluationofdoseefficacyofsorafenibandeffectoftransarterialchemoembolizationinhepatocellularcarcinomapatientsaretrospectivestudy
AT kaojungta evaluationofdoseefficacyofsorafenibandeffectoftransarterialchemoembolizationinhepatocellularcarcinomapatientsaretrospectivestudy