Objective:To evaluate the efficacy and safety in patients with hepatocellular carcinoma treated with sorafenib and determine the predictive factors for survival.Methods:From April 2009 to December 2010,all patients wi...Objective:To evaluate the efficacy and safety in patients with hepatocellular carcinoma treated with sorafenib and determine the predictive factors for survival.Methods:From April 2009 to December 2010,all patients with hepatocellular carcinoma treated with sorafenib were included in the study.Clinical data and survival time were collected.Survival analysis was conducted using the Kaplan-Meier method,and predictive factors for survival were analysed using the Cox's model.Results:A total of 51 patients were included in the study,the median time of follow-up was 10 months(range 1-22).All the 51 patients had one or more adverse events,of which 2 patients died of upper gastrointestinal bleeding and 6 patients discontinued treatment.The mean survival time was 11 months and 1-year survival was 60.8%.On univariate analysis,the median survival time of patients with tumors of BCLC A,B and C were 17,12.5 and 8.5 months,and 1-year survival were 71.4%,61.1%,and 23.1%, respectively(P=0.006).Compared with those with mild and poor arterial supply tumors,patients with good arterial supply tumors had longer median survival time(12 months vs 8 months and 9 months) and higher 1-year survival(52.0%vs 30.8%and 38.5%)(P=0.037).Patients with portal invasion had shorter median survival time and lower 1-year survival(8.5 months vs 13 months and 57.6%vs 16.7%,respectively) than those without(P=0.012).Patients with prealbumin≥170 mg/L had longer median survival time and higher 1-year survival(13.5 months vs 9 months and 55.6%vs 36.4%,respectively) than those with prealbumin<170 mg/L(P=0.016).Early tumor BCLC staging and high level of prealbumin were independent predictive factors for survival on multivariate analysis using Cox's regression model,the hazard ratio were 3.69(95%CI:1.30-10.53,P=0.015) and 3.53(95%CI:1.40-8.91,P=0.008) respectively.Conclusion:Upper gastrointestinal bleeding was a severe event need to be concerned in patients with hepatocellular carcinoma treated with sorafenib.Patients with high level of prealbumin could benefit more from sorafenib treatment,and prealbumin could be a predictor for survival in HCC patients treated with sorafenib.展开更多
基金Supponed by the CSCO-Bayer Schering Research Foundation of Hepatocellular Carcinoma
文摘Objective:To evaluate the efficacy and safety in patients with hepatocellular carcinoma treated with sorafenib and determine the predictive factors for survival.Methods:From April 2009 to December 2010,all patients with hepatocellular carcinoma treated with sorafenib were included in the study.Clinical data and survival time were collected.Survival analysis was conducted using the Kaplan-Meier method,and predictive factors for survival were analysed using the Cox's model.Results:A total of 51 patients were included in the study,the median time of follow-up was 10 months(range 1-22).All the 51 patients had one or more adverse events,of which 2 patients died of upper gastrointestinal bleeding and 6 patients discontinued treatment.The mean survival time was 11 months and 1-year survival was 60.8%.On univariate analysis,the median survival time of patients with tumors of BCLC A,B and C were 17,12.5 and 8.5 months,and 1-year survival were 71.4%,61.1%,and 23.1%, respectively(P=0.006).Compared with those with mild and poor arterial supply tumors,patients with good arterial supply tumors had longer median survival time(12 months vs 8 months and 9 months) and higher 1-year survival(52.0%vs 30.8%and 38.5%)(P=0.037).Patients with portal invasion had shorter median survival time and lower 1-year survival(8.5 months vs 13 months and 57.6%vs 16.7%,respectively) than those without(P=0.012).Patients with prealbumin≥170 mg/L had longer median survival time and higher 1-year survival(13.5 months vs 9 months and 55.6%vs 36.4%,respectively) than those with prealbumin<170 mg/L(P=0.016).Early tumor BCLC staging and high level of prealbumin were independent predictive factors for survival on multivariate analysis using Cox's regression model,the hazard ratio were 3.69(95%CI:1.30-10.53,P=0.015) and 3.53(95%CI:1.40-8.91,P=0.008) respectively.Conclusion:Upper gastrointestinal bleeding was a severe event need to be concerned in patients with hepatocellular carcinoma treated with sorafenib.Patients with high level of prealbumin could benefit more from sorafenib treatment,and prealbumin could be a predictor for survival in HCC patients treated with sorafenib.
