Prognostic factor analysis of moderate-advanced hepatocellular carcinoma treated with sorafenib / 介入放射学杂志

ABSTRACT

Objective To investigate the factors that may affect the prognosis of patients with moderate-advanced hepatocellular carcinoma (HCC) who are receiving sorafonib therapy.Methods The clinical data of 38 HCC patients,whose diagnoses were confirmed by pathology or clinical imaging and were in accord with the Barcelona Clinic Liver Cancer (BCLC) staging criteria,were retrospectively analyzed.Sorafenib 400 mg was orally given twice everyday,and according to modified RECIST criteria the tumor response was evaluated once every 4-6 weeks,the adverse events were recorded,and the drug toxicity was evaluated by grading standard 3.0 edition for common adverse reactions formulated by American National Cancer Institute.Results Among the 38 patients,one patient developed hepatic encephalopathy after took sorafenib for two weeks,and medication had to be stopped.Of other 37 patients,14 patients developed pancreatic atrophy in different degrees (positive group),the median progression free survival (mPFS) was 9.0 months,and the median overall survival (mOS) was 25.8 months;pancreatic atrophy didn't occurred in the remaining 23 patients (negative group),the mPFS was 3.3 months,and the mOS was 8.4 months.The differences in mPFS and in mOS between the two groups were statistically significant (P＜0.01 and P=0.025respectively).The main adverse events included hand-foot skin reaction,diarrhea,fatigue and weight loss,which were relieved after symptomatic treatment,and no severe untoward effect occurred.Conclusion Certain correlation exists between pancreatic atrophy and the curative effect of sorafenib.For patients who develop severe diarrhea associated with pancreatic atrophy,a longer survival time as well as a longer stable state of disease can be expected.(J Intervent Radiol,2017,26258-262)