PDF(Pubmed)
Abstract：
UNASSIGNED: Numerous agents, including immune checkpoint inhibitors, are now available for hepatocellular carcinoma (HCC) treatment. Most trials involving systemic chemotherapy have included patients with Child-Pugh class A, while excluding or minimally enrolling those with Child-Pugh class B, due to liver dysfunction-related mortality. This study aimed to identify prognostic factors for survival in Child-Pugh class B patients receiving sorafenib (SOR), lenvatinib (LEN), atezolizumab plus bevacizumab (ATZ+BEV), or hepatic arterial infusion chemotherapy (HAIC).
UNASSIGNED: From December 2003 to June 2023, 137 patients with advanced HCC receiving systemic chemotherapies (SOR: n=43, LEN: n=16, ATZ+BEV: n=18, HAIC: n=60) were enrolled.
UNASSIGNED: Overall survival (OS) and response rates did not differ significantly across treatments (SOR: 8.3 months, LEN: 10.2 months, ATZ+BEV: 8.5 months, HAIC: 7.3 months). Patients on HAIC and LEN had a lower rate of discontinuing treatment within three months compared to those on ATZ+BEV and SOR. HAIC was associated with fewer changes in ALBI score and better preservation of liver function. Multivariate logistic regression identified serum α-fetoprotein >400 ng/ml [hazard ratio (HR)=1.94; p=0.001], tumor count >5 (HR=1.55; p=0.043), and Child-Pugh score (HR=2.53; p=0.002) as independent predictors of OS.
UNASSIGNED: OS and response rates were similar across systemic chemotherapies. Prognosis for HCC in Child-Pugh class B patients was associated with liver function, necessitating further research for optimal treatment.
UNASSIGNED: From December 2003 to June 2023, 137 patients with advanced HCC receiving systemic chemotherapies (SOR: n=43, LEN: n=16, ATZ+BEV: n=18, HAIC: n=60) were enrolled.
UNASSIGNED: Overall survival (OS) and response rates did not differ significantly across treatments (SOR: 8.3 months, LEN: 10.2 months, ATZ+BEV: 8.5 months, HAIC: 7.3 months). Patients on HAIC and LEN had a lower rate of discontinuing treatment within three months compared to those on ATZ+BEV and SOR. HAIC was associated with fewer changes in ALBI score and better preservation of liver function. Multivariate logistic regression identified serum α-fetoprotein >400 ng/ml [hazard ratio (HR)=1.94; p=0.001], tumor count >5 (HR=1.55; p=0.043), and Child-Pugh score (HR=2.53; p=0.002) as independent predictors of OS.
UNASSIGNED: OS and response rates were similar across systemic chemotherapies. Prognosis for HCC in Child-Pugh class B patients was associated with liver function, necessitating further research for optimal treatment.
摘要：
■众多代理商，包括免疫检查点抑制剂，现在可用于肝细胞癌（HCC）治疗。大多数涉及全身化疗的试验包括Child-PughA级患者，在排除或最低限度地招收儿童普格乙级患者的同时，由于肝功能障碍相关的死亡率。本研究旨在确定接受索拉非尼（SOR）的Child-PughB级患者生存的预后因素。乐伐替尼（LEN），阿替珠单抗加贝伐单抗（ATZ+BEV），或肝动脉灌注化疗（HAIC）。
■从2003年12月至2023年6月，137例接受全身化疗的晚期HCC患者（SOR：n=43，LEN：n=16，ATZBEV：n=18，HAIC：n=60）入组。
■不同治疗组的总生存期（OS）和反应率没有显著差异（SOR：8.3个月，LEN:10.2个月,ATZ+BEV：8.5个月，HAIC：7.3个月）。与接受ATZBEV和SOR的患者相比，接受HAIC和LEN的患者在三个月内停止治疗的比率较低。HAIC与ALBI评分变化较少、肝功能保存较好相关。多因素logistic回归确定血清甲胎蛋白>400ng/ml[风险比（HR）=1.94；p=0.001]，肿瘤计数>5（HR=1.55；p=0.043），Child-Pugh评分（HR=2.53；p=0.002）是OS的独立预测因子。
■全身化疗的OS和反应率相似。Child-PughB级肝癌患者的预后与肝功能相关，需要进一步研究以进行最佳治疗。
■从2003年12月至2023年6月，137例接受全身化疗的晚期HCC患者（SOR：n=43，LEN：n=16，ATZBEV：n=18，HAIC：n=60）入组。
■不同治疗组的总生存期（OS）和反应率没有显著差异（SOR：8.3个月，LEN:10.2个月,ATZ+BEV：8.5个月，HAIC：7.3个月）。与接受ATZBEV和SOR的患者相比，接受HAIC和LEN的患者在三个月内停止治疗的比率较低。HAIC与ALBI评分变化较少、肝功能保存较好相关。多因素logistic回归确定血清甲胎蛋白>400ng/ml[风险比（HR）=1.94；p=0.001]，肿瘤计数>5（HR=1.55；p=0.043），Child-Pugh评分（HR=2.53；p=0.002）是OS的独立预测因子。
■全身化疗的OS和反应率相似。Child-PughB级肝癌患者的预后与肝功能相关，需要进一步研究以进行最佳治疗。
