TITLE:
Sorafenib after Arterial Chemoembolization in Child-Pugh A and B Cirrhotic Patients with Intermediate Hepatocellular Carcinoma: A Retrospective Analysis
AUTHORS:
Fernando Gomes Romeiro, Luciana Yumi Odani Sigahi, Matheus Alvarez, Fabio da Silva Yamashiro, Fábio Cardoso de Carvalho, Leonardo Pelafsky, Talles Bazeia Lima, Letícia de Campos Franzoni, José Ricardo de Arruda Miranda, Giovanni Faria Silva
KEYWORDS:
Hepatocellular Carcinoma, Cirrhosis, Arterial Chemoembolization, Sorafenib
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.6 No.3,
March
19,
2015
ABSTRACT: Introduction: Hepatocellular carcinoma
(HCC) is a leading cause of mortality among cirrhotic patients, and current
guidelines recommend single-treatment modalities according to patient and liver
disease classifications. New studies have shown promising results from
combining locoregional and systemic treatments, but most of them were limited
to Child-Pugh A patients due to toxicity concerns. Aim: The objective of this
study was to analyze survival rates of Child-Pugh A and B patients with
intermediate HCC tumors treated with transarterial chemoembolization (TACE)
followed by full-dose sorafenib usage. Material and methods: a retrospective
analysis of 37 cirrhotic patients (Child-Pugh A and B rates = 23/14) treated
with TACE and TACE followed by sorafenib usage (17 and 20 patients,
respectively). Results: The mean survival was 379 days in the combined
treatment group and 151 days in the single-treatment group (p = 0.007). There
were no differences in survival according to the Child-Pugh classification.
Conclusions: sorafenib after TACE can be an option for selected cirrhotic
patients with intermediate HCC tumors if this combined approach is cautiously
performed on an individualized schedule. Our results suggest that the
Child-Pugh classification should not be a limitation to this combined
treatment.