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

Clinical and Molecular Hepatology 2017년 23권 2호 p.128 ~ p.137

양현(Yang Hyun) - Catholic University College of Medicine Department of Internal Medicine
우현영(Woo Hyun-Young) - Pusan National University College of Medicine Department of Internal Medicine
이순규(Lee Soon-Kyu) - Catholic University College of Medicine Department of Internal Medicine
장보현(Jang Bo-Hyun) - Catholic University College of Medicine Department of Internal Medicine
남희철(Nam Hee-Chul) - Catholic University College of Medicine Department of Internal Medicine
이해림(Lee Hae-Lim) - Catholic University College of Medicine Department of Internal Medicine
이성원(Lee Sung-Won) - Catholic University College of Medicine Department of Internal Medicine
송도선(Song Do-Seon) - Catholic University School of Medicine Department of Internal Medicine
송명준(Song Myeong-Jun) - Catholic University College of Medicine Department of Internal Medicine
오정석(Oh Jung-Suk) - Catholic University College of Medicine Department of Internal Medicine

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.