Efficacy and Safety of Hepatic Arterial Infusion Therapy with Cinobufacini in Advanced Hepatocellular Carcinoma with Macrovascular Invasion: A Retrospective Cohort Study

IF 2.5 4区医学 Q3 ONCOLOGY

Cancer Management and Research Pub Date : 2024-03-14 DOI:10.2147/cmar.s440017

Tao Xue, Hongbin Yu, Wenming Feng, Yao Wang, Shiyong Wu, Lili Wang, Peiqin Zhu, Jianming Guan, Quan Sun

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引用次数: 0

Abstract

Background: The presence of macrovascular invasion (MVI) is associated with poor prognosis in advanced hepatocellular carcinoma (HCC). This study aims to evaluate the efficacy and safety of Cinobufacini therapy via hepatic arterial infusion (HAI) in advanced HCC patients with MVI.
Methods: The clinical records of 130 consecutive patients with unresectable advanced HCC and MVI who had received Cinobufacini or cisplatin plus 5-fluorouracil (CF) treatment via HAI were retrospectively analyzed. The therapeutic efficacy, overall survival (OS), progression-free survival (PFS), and adverse events were compared between the two treatment groups.
Results: The Cinobufacini group demonstrated significant curative effects on treatment via HAI compared with the CF group, including the objective response rate (44.9% vs 27.9%, P=0.048), the median OS (14.8 months vs 11.1 months, P=0.010), and the median PFS (10.3 months vs 6.0 months, P=0.006). Result in subgroup analysis of portal vein invasion grade supported the efficacy in Cinobufacini treatment, especially in the median OS of Vp1-2 (18.3 months vs 14.3 months, P=0.043) and Vp3 (15.0 months vs 11.4 months, P=0.046), as well as the median PFS of Vp1-2 (14.8 months vs 10.2 months, P=0.028) and Vp3 (10.8 months vs 6.6 months, P=0.033) compared with CF treatment. Cox proportional hazards model and forest plot analysis of factors confirmed the survival benefit from HAI with Cinobufacini over CF (hazard ratio [HR], 0.61; 95% CI: 0.40– 0.91; P=0.010). Multivariable analysis identified portal vein invasion grade (Vp4; HR, 1.78; 95% CI: 1.03– 2.16; P=0.032) and AFP (> 1000; HR, 1.61; 95% CI: 1.08– 1.91; P=0.039) as the independent factors for prognosis. Moreover, the total incidence of adverse events in the Cinobufacini group was significantly lower than in the CF group (60.9% vs 82.0%, P=0.009).
Conclusion: Cinobufacini therapy via HAI is a viable strategy for curing advanced HCC with MVI, due to prolonged survival and a superior safety profile.

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西诺巴昔尼对大血管侵犯的晚期肝细胞癌进行肝动脉灌注治疗的有效性和安全性：一项回顾性队列研究

背景：大血管侵犯（MVI）的存在与晚期肝细胞癌（HCC）的不良预后有关。本研究旨在评估通过肝动脉输注（HAI）对伴有大血管侵犯的晚期 HCC 患者进行西诺布卡尼治疗的有效性和安全性：方法：回顾性分析了130例连续接受Cinobufacini或顺铂加5-氟尿嘧啶（CF）肝动脉输注治疗的不可切除晚期HCC合并MVI患者的临床记录。比较了两组患者的疗效、总生存期（OS）、无进展生存期（PFS）和不良反应：结果：与 CF 组相比，Cinobufacini 组通过 HAI 治疗取得了显著的疗效，包括客观反应率（44.9% vs 27.9%，P=0.048）、中位 OS（14.8 个月 vs 11.1 个月，P=0.010）和中位 PFS（10.3 个月 vs 6.0 个月，P=0.006）。门静脉侵犯分级亚组分析结果支持西诺巴昔尼治疗的疗效，尤其是与CF治疗相比，Vp1-2（18.3个月 vs 14.3个月，P=0.043）和Vp3（15.0个月 vs 11.4个月，P=0.046）的中位OS，以及Vp1-2（14.8个月 vs 10.2个月，P=0.028）和Vp3（10.8个月 vs 6.6个月，P=0.033）的中位PFS。Cox比例危险模型和因素森林图分析证实，与CF相比，使用西诺巴昔尼进行HAI治疗可提高生存率（危险比[HR]，0.61；95% CI：0.40- 0.91；P=0.010）。多变量分析发现，门静脉侵犯分级（Vp4；HR，1.78；95% CI：1.03- 2.16；P=0.032）和 AFP（>；1000；HR，1.61；95% CI：1.08- 1.91；P=0.039）是影响预后的独立因素。此外，西诺布法西尼组的不良反应总发生率明显低于CF组（60.9% vs 82.0%，P=0.009）：结论：通过HAI进行西诺布卡尼治疗是治愈伴有MVI的晚期HCC的一种可行策略，因为它能延长患者的生存期，而且安全性更高。

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来源期刊

Cancer Management and Research Medicine-Oncology

CiteScore

7.40

自引率

0.00%

发文量

448

审稿时长

16 weeks

期刊介绍： Cancer Management and Research is an international, peer reviewed, open access journal focusing on cancer research and the optimal use of preventative and integrated treatment interventions to achieve improved outcomes, enhanced survival, and quality of life for cancer patients. Specific topics covered in the journal include: ◦Epidemiology, detection and screening ◦Cellular research and biomarkers ◦Identification of biotargets and agents with novel mechanisms of action ◦Optimal clinical use of existing anticancer agents, including combination therapies ◦Radiation and surgery ◦Palliative care ◦Patient adherence, quality of life, satisfaction The journal welcomes submitted papers covering original research, basic science, clinical & epidemiological studies, reviews & evaluations, guidelines, expert opinion and commentary, and case series that shed novel insights on a disease or disease subtype.