PDF(Pubmed)
Abstract：
UNASSIGNED: To compare the efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) with transarterial chemoembolization (TACE) for the treatment of high-risk hepatocellular carcinoma (hHCC) patients.
UNASSIGNED: Between January 2014 and August 2022, a total of 1765 consecutive patients with hHCC who underwent initial intra-arterial therapies were reviewed and divided into a TACE group (n, 507) and a HAIC group (n, 426). The study used propensity score matching (PSM) to reduce selectivity bias. Overall survival (OS) and progression-free survival (PFS) were compared using Kaplan‒Meier curves with the Log rank test. The objective response rate (ORR), conversion surgery rate (CSR) adverse event (AE) comparison and subgroup analysis were performed between the two groups.
UNASSIGNED: After PSM 1:1, 444 patients were divided into two groups. The patients with hHCC who received HAIC had higher median PFS (6.1 vs 3.3 months, P < 0.001) and OS (10.3 vs 8.2 months, P=0.303) than TACE. Higher ORR (24.8% vs 11.7%) and CSR (15.5% vs 8.9%) were found in the HAIC group than in the TACE group (both P < 0.05). The incidence of grade 3/4 AE was 23.9% and 8.1% in the TACE and HAIC groups, respectively. The subgroup analysis suggest that HAIC appeared to particularly benefit patients with tumor diameter of more than 10 centimeters (hazard ratio [HR], 0.6; 95% CI, 0.47-0.77; p, 0.00) and PVTT Vp4 (HR, 0.56; 95% CI, 0.39-0.8; P, 0.01) for PFS outperforming TACE.
UNASSIGNED: HAIC can provide better disease control for hHCC than cTACE, with a comparable long-term OS and safety.
UNASSIGNED: Between January 2014 and August 2022, a total of 1765 consecutive patients with hHCC who underwent initial intra-arterial therapies were reviewed and divided into a TACE group (n, 507) and a HAIC group (n, 426). The study used propensity score matching (PSM) to reduce selectivity bias. Overall survival (OS) and progression-free survival (PFS) were compared using Kaplan‒Meier curves with the Log rank test. The objective response rate (ORR), conversion surgery rate (CSR) adverse event (AE) comparison and subgroup analysis were performed between the two groups.
UNASSIGNED: After PSM 1:1, 444 patients were divided into two groups. The patients with hHCC who received HAIC had higher median PFS (6.1 vs 3.3 months, P < 0.001) and OS (10.3 vs 8.2 months, P=0.303) than TACE. Higher ORR (24.8% vs 11.7%) and CSR (15.5% vs 8.9%) were found in the HAIC group than in the TACE group (both P < 0.05). The incidence of grade 3/4 AE was 23.9% and 8.1% in the TACE and HAIC groups, respectively. The subgroup analysis suggest that HAIC appeared to particularly benefit patients with tumor diameter of more than 10 centimeters (hazard ratio [HR], 0.6; 95% CI, 0.47-0.77; p, 0.00) and PVTT Vp4 (HR, 0.56; 95% CI, 0.39-0.8; P, 0.01) for PFS outperforming TACE.
UNASSIGNED: HAIC can provide better disease control for hHCC than cTACE, with a comparable long-term OS and safety.
摘要：
■比较肝动脉灌注化疗（HAIC）与经动脉化疗栓塞（TACE）治疗高危肝细胞癌（hHCC）患者的疗效和安全性。
■在2014年1月至2022年8月之间，共审查了1765例接受初始动脉内治疗的hHCC连续患者，并将其分为TACE组（n，507)和HAIC组(n，426).该研究使用倾向评分匹配(PSM)来减少选择性偏差。使用Kaplan-Meier曲线和Log秩检验比较总生存期（OS）和无进展生存期（PFS）。客观反应率(ORR)，对两组患者的中转手术率(CSR)不良事件(AE)进行比较和亚组分析.
■PSM1:1后，将444例患者分为两组。接受HAIC的hHCC患者的中位PFS较高（6.1vs3.3个月，P<0.001）和OS（10.3vs8.2个月，P=0.303）比TACE。HAIC组ORR(24.8%vs11.7%)和CSR(15.5%vs8.9%)高于TACE组(均P<0.05)。TACE和HAIC组3/4级不良事件发生率分别为23.9%和8.1%,分别。亚组分析表明，HAIC似乎对肿瘤直径超过10厘米的患者特别有益（风险比[HR]，0.6；95%CI，0.47-0.77；p，0.00）和PVTTVp4（HR，0.56；95%CI，0.39-0.8；P，0.01）的PFS表现优于TACE。
■HAIC可以为hHCC提供比cTACE更好的疾病控制，具有可比的长期操作系统和安全性。
■在2014年1月至2022年8月之间，共审查了1765例接受初始动脉内治疗的hHCC连续患者，并将其分为TACE组（n，507)和HAIC组(n，426).该研究使用倾向评分匹配(PSM)来减少选择性偏差。使用Kaplan-Meier曲线和Log秩检验比较总生存期（OS）和无进展生存期（PFS）。客观反应率(ORR)，对两组患者的中转手术率(CSR)不良事件(AE)进行比较和亚组分析.
■PSM1:1后，将444例患者分为两组。接受HAIC的hHCC患者的中位PFS较高（6.1vs3.3个月，P<0.001）和OS（10.3vs8.2个月，P=0.303）比TACE。HAIC组ORR(24.8%vs11.7%)和CSR(15.5%vs8.9%)高于TACE组(均P<0.05)。TACE和HAIC组3/4级不良事件发生率分别为23.9%和8.1%,分别。亚组分析表明，HAIC似乎对肿瘤直径超过10厘米的患者特别有益（风险比[HR]，0.6；95%CI，0.47-0.77；p，0.00）和PVTTVp4（HR，0.56；95%CI，0.39-0.8；P，0.01）的PFS表现优于TACE。
■HAIC可以为hHCC提供比cTACE更好的疾病控制，具有可比的长期操作系统和安全性。
