Sorafenib and hepatic arterial infusion chemotherapy for unresectable advanced hepatocellular carcinoma: A comparative study

Hiramine,Yasunari; Uto,Hirofumi; Imamura,Yasushi; Tabu,Kazuaki; Baba,Yoshirou; Hiwaki,Takuya; Sho,Yukihiko; Tahara,Kenji; Higashi,Hirofumi; Tamai,Tutomu; Oketani,Makoto; Ido,Akio; Tsubouchi,Hirohito

doi:10.3892/etm.2011.237

Sorafenib and hepatic arterial infusion chemotherapy for unresectable advanced hepatocellular carcinoma: A comparative study

Authors:
- Yasunari Hiramine
- Hirofumi Uto
- Yasushi Imamura
- Kazuaki Tabu
- Yoshirou Baba
- Takuya Hiwaki
- Yukihiko Sho
- Kenji Tahara
- Hirofumi Higashi
- Tutomu Tamai
- Makoto Oketani
- Akio Ido
- Hirohito Tsubouchi
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Affiliations: Department of Internal Medicine, Kagoshima Kouseiren Hospital, Kagoshima 890-0061, Japan, Department of Digestive and Lifestyle-Related Disease, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8520, Japan, Department of Hygiene and Public Health, School of Medicine, National Institute of Fitness and Sports in Kanoya, Kanoya, Kagoshima 891-2393, Japan, Department of Digestive and Lifestyle-Related Disease, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8520, Japan
Published online on: March 21, 2011 https://doi.org/10.3892/etm.2011.237
Pages: 433-441

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Abstract

Sorafenib is a kinase-targeted drug that has high efficacy for advanced hepatocellular carcinoma (HCC). The aim of the present study was to determine whether sorafenib is more effective than hepatic arterial infusion chemotherapy (HAIC) for HCC. Twenty patients treated with sorafenib (sorafenib group) initiated at 800 mg/day and 45 patients treated with HAIC (HAIC group) for unresectable Child-Pugh A advanced HCC were investigated retrospectively. The treatment effect was assessed using the Response Evaluation Criteria in Solid Tumors (RECIST). As a result, the overall response rate was significantly lower in the sorafenib group than in the HAIC group (P=0.03), while the disease control and survival rates did not differ between the two groups. In the sorafenib group, treatment was discontinued in 19 patients, including 12 due to side effects. In subgroups of patients treated with sorafenib, the survival rate was significantly lower in patients (n=11) administered sorafenib for <60 days compared to those (n=9) treated for ≥60 days. A shorter treatment period (<60 days) was an independent risk factor for unfavorable survival [hazard ratio (HR), 3.34; 95% confidence interval (CI), 1.45-7.66 vs. HAIC], while survival in patients treated with sorafenib for ≥60 days did not differ from those treated with HAIC (HR, 0.79; 95% CI, 0.27-2.34). In conclusion, the disease control and survival rates of patients treated with sorafenib for advanced HCC were comparable to such rates in patients treated with HAIC. However, the prognosis was poor when long-term sorafenib treatment was not possible due to side effects, demonstrating the importance of patient selection for sorafenib treatment.

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