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Ann. hepatol ; 16(2): 247-254, Mar.-Apr. 2017. tab, graf
Artículo en Inglés | LILACS | ID: biblio-887229

RESUMEN

ABSTRACT Background & Aim. Transarterial chemoembolization (TACE) or sorafenib is recommended for hepatocellular carcinoma BCLC stages B and C respectively. We studied the role of combination of TACE and sorafenib in BCLC stages B/C. Material and methods. We undertook an observational study on a cohort of cirrhotics with HCC from August 2010 through October 2014. Patients in BCLC stages B/C who had received TACE and/or sorafenib were included. mRECIST criteria were used to assess tumor response. The primary end point was overall survival. Results. Out of 124 patients, 47.6% were in BCLC-B and 52.4% in BCLCC. Baseline characteristics were comparable. The predominant etiology was cryptogenic (37.2% and 38.5%, p = NS). 49.1% in BCLC-B and 56.9% in BCLC-C had received TACE+sorafenib. In BCLC-B, the overall survival improved from 9 months (95% CI 6.3-11.7) using TACE only to 16 months (95% CI 12.9-19.1) using TACE+sorafenib (p < 0.05). In BCLC-C, addition of TACE to sorafenib improved the overall survival from 4 months (95%CI 3-5) to 9 months (95%CI 6.8-11.2) (p < 0.0001). As per mRECIST criteria, patients on TACE+sorafenib had reduced progressive disease (37.8% vs. 83.3%), improved partial response (43.2% vs. 3.3%) and one had complete response compared to those on sorafenib alone (p < 0.0001) in BCLC-C but not in BCLC-B group. Hand foot syndrome was noted in 27.7% patients on sorafenib and post TACE syndrome in 80.2% patients, but both were reversible. No major adverse events were noted. Conclusion. TACE+sorafenib was more effective than TACE or sorafenib alone in HCC BCLC stages B or C with a significant survival benefit and improved tumour regression especially in BCLC-C patients.


Asunto(s)
Humanos , Compuestos de Fenilurea/uso terapéutico , Niacinamida/análogos & derivados , Carcinoma Hepatocelular/terapia , Inhibidores de Proteínas Quinasas/uso terapéutico , Neoplasias Hepáticas/terapia , Antineoplásicos/uso terapéutico , Compuestos de Fenilurea/efectos adversos , Factores de Tiempo , Resultado del Tratamiento , Quimioembolización Terapéutica/efectos adversos , Quimioembolización Terapéutica/mortalidad , Niacinamida/efectos adversos , Niacinamida/uso terapéutico , Carcinoma Hepatocelular/etiología , Carcinoma Hepatocelular/mortalidad , Carcinoma Hepatocelular/patología , Inhibidores de Proteínas Quinasas/efectos adversos , Carga Tumoral , Estimación de Kaplan-Meier , Neoplasias Hepáticas/etiología , Neoplasias Hepáticas/mortalidad , Estadificación de Neoplasias , Antineoplásicos/efectos adversos
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