PDF(Pubmed)
Abstract：
UNASSIGNED: The selection of an efficacious treatment modality for patients with hepatocellular carcinoma (HCC) diagnosed as refractory to transarterial chemoembolization (TACE) presents numerous challenges. In addition to systemic therapies, hepatic arterial infusion chemotherapy (HAIC) may serve as an alternative option. However, it is imperative to identify patients who are appropriate candidates for HAIC to confer a survival benefit. Our study aimed to evaluate the impact of the number of TACE sessions prior to HAIC treatment and the addition of TACE during HAIC on the survival of HCC patient\'s refractory to TACE.
UNASSIGNED: This retrospective study included 82 patients with HCC refractory to TACE (mean age 60.5 years, 75 males). Survival analysis was conducted using the Kaplan-Meier method, with comparison between two groups via the log-rank test; the Cox regression model was utilized to identify factors influencing survival.
UNASSIGNED: The overall response rate (ORR) was observed to be 29.3%, with a disease control rate (DCR) of 56.1%. Patients receiving more than four TACE sessions prior to HAIC exhibited a significantly poorer survival prognosis compared to those receiving fewer than four TACE sessions, with a hazard ratio (HR) of 0.151 (P=0.02). The median overall survival (OS) was markedly different, being 3.4 (range, 0.5-13.6) months for the former group and 14 (range, 8.5-19.5) months for the latter (P=0.01). Furthermore, patients undergoing additional TACE while receiving HAIC treatment demonstrated improved survival outcomes compared to those who did not, with an HR of 0.491 (P=0.02); the respective OS for these groups was 14 (range, 3.6-14.4) and 6.7 (range, 2.8-11) months (P=0.02).
UNASSIGNED: HAIC can be a suitable alternative treatment for HCC patient\'s refractory to TACE. For those with a history of more than 4 TACE sessions, other alternative treatments should be considered. The addition of TACE during HAIC treatment may extend patient OS time, provided it is balanced with maintaining safe liver function.
UNASSIGNED: This retrospective study included 82 patients with HCC refractory to TACE (mean age 60.5 years, 75 males). Survival analysis was conducted using the Kaplan-Meier method, with comparison between two groups via the log-rank test; the Cox regression model was utilized to identify factors influencing survival.
UNASSIGNED: The overall response rate (ORR) was observed to be 29.3%, with a disease control rate (DCR) of 56.1%. Patients receiving more than four TACE sessions prior to HAIC exhibited a significantly poorer survival prognosis compared to those receiving fewer than four TACE sessions, with a hazard ratio (HR) of 0.151 (P=0.02). The median overall survival (OS) was markedly different, being 3.4 (range, 0.5-13.6) months for the former group and 14 (range, 8.5-19.5) months for the latter (P=0.01). Furthermore, patients undergoing additional TACE while receiving HAIC treatment demonstrated improved survival outcomes compared to those who did not, with an HR of 0.491 (P=0.02); the respective OS for these groups was 14 (range, 3.6-14.4) and 6.7 (range, 2.8-11) months (P=0.02).
UNASSIGNED: HAIC can be a suitable alternative treatment for HCC patient\'s refractory to TACE. For those with a history of more than 4 TACE sessions, other alternative treatments should be considered. The addition of TACE during HAIC treatment may extend patient OS time, provided it is balanced with maintaining safe liver function.
摘要：
■对于诊断为经肝动脉化疗栓塞（TACE）难治性的肝细胞癌（HCC）患者，选择有效的治疗方式提出了许多挑战。除了全身治疗，肝动脉灌注化疗(HAIC)可作为另一种选择.然而,必须确定适合HAIC治疗的患者,以获得生存获益.我们的研究旨在评估HAIC治疗前TACE治疗次数和HAIC期间添加TACE对TACE难治性HCC患者生存率的影响。
■这项回顾性研究包括82例TACE难治性HCC患者（平均年龄60.5岁，75男性）。使用Kaplan-Meier方法进行生存分析，通过对数秩检验比较两组;Cox回归模型用于确定影响生存的因素。
■观察到总有效率（ORR）为29.3％，疾病控制率（DCR）为56.1%。与接受少于四次TACE治疗的患者相比，在HAIC之前接受四次以上TACE治疗的患者表现出明显较差的生存预后。风险比（HR）为0.151（P=0.02）。中位总生存期（OS）有显著差异，为3.4（范围，前组0.5-13.6)个月和14(范围，后者为8.5-19.5个月(P=0.01)。此外，与未接受HAIC治疗的患者相比，接受额外TACE治疗的患者的生存结局有所改善，HR为0.491（P=0.02）；这些组的相应OS为14（范围，3.6-14.4）和6.7（范围，2.8-11个月（P=0.02）。
■HAIC可能是TACE难治性HCC患者的合适替代治疗方法。对于那些拥有超过4次TACE会议历史的人来说，应考虑其他替代疗法。在HAIC治疗期间添加TACE可能会延长患者的OS时间，只要它是平衡与维持安全的肝功能。
■这项回顾性研究包括82例TACE难治性HCC患者（平均年龄60.5岁，75男性）。使用Kaplan-Meier方法进行生存分析，通过对数秩检验比较两组;Cox回归模型用于确定影响生存的因素。
■观察到总有效率（ORR）为29.3％，疾病控制率（DCR）为56.1%。与接受少于四次TACE治疗的患者相比，在HAIC之前接受四次以上TACE治疗的患者表现出明显较差的生存预后。风险比（HR）为0.151（P=0.02）。中位总生存期（OS）有显著差异，为3.4（范围，前组0.5-13.6)个月和14(范围，后者为8.5-19.5个月(P=0.01)。此外，与未接受HAIC治疗的患者相比，接受额外TACE治疗的患者的生存结局有所改善，HR为0.491（P=0.02）；这些组的相应OS为14（范围，3.6-14.4）和6.7（范围，2.8-11个月（P=0.02）。
■HAIC可能是TACE难治性HCC患者的合适替代治疗方法。对于那些拥有超过4次TACE会议历史的人来说，应考虑其他替代疗法。在HAIC治疗期间添加TACE可能会延长患者的OS时间，只要它是平衡与维持安全的肝功能。
