PDF(Pubmed)
Abstract：
BACKGROUND: The CRAFITY score serves as a simple and effective predictive model for individuals diagnosed with hepatocellular carcinoma (HCC) and subjected to treatment with atezolizumab and bevacizumab (Atez/Bev). However, no large sample size studies have reported the application of the CRAFITY score among HCC patients undergoing transarterial chemoembolization (TACE) in conjunction with lenvatinib. This research aims to assess the prognostic role of the CRAFITY score in the context of individuals with HCC receiving TACE in combination with lenvatinib.
METHODS: This retrospective analysis encompassed 314 individuals diagnosed with HCC who underwent the combination of TACE and lenvatinib at two medical facilities in China from August 2019 to August 2022 (comprising a training cohort of n = 172 and a validation cohort of n = 142). We investigated the prognostic values of overall survival (OS), progression-free survival (PFS), disease control rate, and objective response rate in the training cohort based on the CRAFITY scores. Furthermore, the predictive capacity of the model was corroborated through validation using an external cohort.
RESULTS: We included 174 and 142 patients treated with TACE plus lenvatinib in the training and validation cohorts, correspondingly. PFS and OS differed across all three groups in all training and validation cohorts, based on the CRAFITY score (p < 0.001). In both cohorts, the CRAFITY score effectively predicted tumor response (p < 0.001). Moreover, among the 121 patients who received TACE, lenvatinib, and immunotherapy, the CRAFITY score showed promising predictive efficacy in PFS and OS.
CONCLUSIONS: The CRAFITY score, utilizing C-reactive protein and alpha-fetoprotein values, emerges as a dependable and pragmatic instrument for forecasting the effectiveness of TACE plus lenvatinib in individuals with unresectable HCC. This scoring system holds the potential to assist oncologists in making informed clinical decisions.
METHODS: This retrospective analysis encompassed 314 individuals diagnosed with HCC who underwent the combination of TACE and lenvatinib at two medical facilities in China from August 2019 to August 2022 (comprising a training cohort of n = 172 and a validation cohort of n = 142). We investigated the prognostic values of overall survival (OS), progression-free survival (PFS), disease control rate, and objective response rate in the training cohort based on the CRAFITY scores. Furthermore, the predictive capacity of the model was corroborated through validation using an external cohort.
RESULTS: We included 174 and 142 patients treated with TACE plus lenvatinib in the training and validation cohorts, correspondingly. PFS and OS differed across all three groups in all training and validation cohorts, based on the CRAFITY score (p < 0.001). In both cohorts, the CRAFITY score effectively predicted tumor response (p < 0.001). Moreover, among the 121 patients who received TACE, lenvatinib, and immunotherapy, the CRAFITY score showed promising predictive efficacy in PFS and OS.
CONCLUSIONS: The CRAFITY score, utilizing C-reactive protein and alpha-fetoprotein values, emerges as a dependable and pragmatic instrument for forecasting the effectiveness of TACE plus lenvatinib in individuals with unresectable HCC. This scoring system holds the potential to assist oncologists in making informed clinical decisions.
摘要：
背景：CRAFITY评分是诊断为肝细胞癌（HCC）并接受阿特珠单抗和贝伐单抗（Atez/Bev）治疗的个体的简单有效的预测模型。然而,尚无大样本量研究报道CRAFITY评分在联合应用经肝动脉化疗栓塞(TACE)的HCC患者中的应用.这项研究旨在评估CRAFITY评分在接受TACE联合lenvatinib的HCC患者中的预后作用。
方法：这项回顾性分析涵盖了2019年8月至2022年8月在中国两家医疗机构接受TACE和lenvatinib联合治疗的314例HCC患者（包括n=172的培训队列和n=142的验证队列）。我们调查了总生存期(OS)的预后价值，无进展生存期（PFS），疾病控制率,和基于CRAFITY评分的训练队列中的客观应答率。此外，通过使用外部队列进行验证,证实了模型的预测能力.
结果：我们在训练和验证队列中纳入了174和142例接受TACE联合来伐替尼治疗的患者，相应地。在所有培训和验证队列中，所有三组的PFS和OS都不同，基于CRAFITY评分（p<0.001）。在这两个队列中，CRAFITY评分可有效预测肿瘤反应(p<0.001)。此外，在接受TACE治疗的121名患者中，lenvatinib,和免疫疗法，CRAFITY评分在PFS和OS方面显示出良好的预测功效.
结论：残酷评分，利用C反应蛋白和甲胎蛋白值，作为预测TACE加lenvatinib在不可切除HCC患者中的有效性的可靠和实用的工具。这种评分系统有可能帮助肿瘤学家做出明智的临床决定。
方法：这项回顾性分析涵盖了2019年8月至2022年8月在中国两家医疗机构接受TACE和lenvatinib联合治疗的314例HCC患者（包括n=172的培训队列和n=142的验证队列）。我们调查了总生存期(OS)的预后价值，无进展生存期（PFS），疾病控制率,和基于CRAFITY评分的训练队列中的客观应答率。此外，通过使用外部队列进行验证,证实了模型的预测能力.
结果：我们在训练和验证队列中纳入了174和142例接受TACE联合来伐替尼治疗的患者，相应地。在所有培训和验证队列中，所有三组的PFS和OS都不同，基于CRAFITY评分（p<0.001）。在这两个队列中，CRAFITY评分可有效预测肿瘤反应(p<0.001)。此外，在接受TACE治疗的121名患者中，lenvatinib,和免疫疗法，CRAFITY评分在PFS和OS方面显示出良好的预测功效.
结论：残酷评分，利用C反应蛋白和甲胎蛋白值，作为预测TACE加lenvatinib在不可切除HCC患者中的有效性的可靠和实用的工具。这种评分系统有可能帮助肿瘤学家做出明智的临床决定。
