Clin Mol Hepatol.  2017 Jun;23(2):128-137. 10.3350/cmh.2016.0071.

A comparative study of sorafenib and metronomic chemotherapy for Barcelona Clinic Liver Cancer-stage C hepatocellular carcinoma with poor liver function

Affiliations
  • 1Department of Internal Medicine, The Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Korea. baesh@catholic.ac.kr
  • 2Department of Internal Medicine and Medical Research Institute, Pusan National University College of Medicine, Pusan, Korea.
  • 3Department of Radiology, The Catholic University of Korea, Seoul, Korea.
  • 4Department of Internal Medicine, Makati Medical Center, Manila, Philippines.

Abstract

BACKGROUND/AIMS
Metronomic chemotherapy (MET) is frequently administered in comparatively low doses as a continuous chemotherapeutic agent. The aim of this study was to evaluate the feasibility and overall survival (OS) of MET compared to sorafenib for advanced hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT).
METHODS
A total of 54 patients with advanced HCC and PVTT who had undergone MET were analyzed between 2005 and 2013. A total of 53 patients who had undergone sorafenib therapy were analyzed as the control group. The primary endpoint of this study was OS.
RESULTS
The median number of MET cycles was two (1-15). The OS values for the MET group and sorafenib group were 158 days (132-184) and 117 days (92-142), respectively (P=0.029). The Cox proportional-hazard model showed that a higher risk of death was correlated with higher serum alpha fetoprotein level (≥400 mg/dL, hazard ratio [HR]=1.680, P=0.014) and Child-Pugh class B (HR=1.856, P=0.008).
CONCLUSIONS
MET was associated with more favorable outcomes in terms of overall survival than was sorafenib in patients with advanced HCC with PVTT, especially in patients with poor liver function. Therefore, MET can be considered as a treatment option in patients with advanced HCC with PVTT and poor liver function.

Keyword

Carcinoma, Hepatocellular; Administration, Metronomic; Portal vein; Sorafenib; Thrombosis
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