FOLFOX-Based Hepatic Arterial Infusion Chemotherapy with Sequential Drug-Eluting Bead Transarterial Chemoembolization for Unresectable Large Hepatocellular Carcinoma: A Single-Center Retrospective Cohort Study.

IF 4.2 3区 医学 Q2 ONCOLOGY
Journal of Hepatocellular Carcinoma Pub Date : 2024-10-28 eCollection Date: 2024-01-01 DOI:10.2147/JHC.S493577
Rongce Zhao, Jing Zhou, Zehao Zheng, Xinhao Xiong, Qiaoxuan Wang, Shaohua Li, Wei Wei, Rongping Guo
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引用次数: 0

Abstract

Background: For patients with large unresectable hepatocellular carcinoma (HCC), the effectiveness of conventional transarterial chemoembolization (TACE) remains suboptimal, which necessitates the administration of substantial volumes of chemotherapy drugs and lipiodol, thereby increasing the risk of liver failure and other chemotherapy-related complications. Therefore, we devised a strategy of initial hepatic arterial infusion chemotherapy (HAIC) followed by sequential drug-eluting bead TACE (DEB-TACE). In our treatment design, a lower tumor burden after HAIC facilitated complete embolization of tumor vasculature, and the use of less amount of embolic agents reduced the incidence of liver failure and embolization syndromes.

Methods: This retrospective study evaluated consecutive patients with unresectable large HCC with a maximum tumor diameter of ≥7 cm who received FOLFOX-HAIC combined with sequential DEB-TACE from April 2019 to February 2024. Efficacy was evaluated using the objective response rate (ORR), overall survival (OS), and progression-free survival (PFS); and safety was assessed using the frequency of key adverse events (AEs).

Results: Among the 76 patients included, the median maximum tumor diameter was 12.4 cm (range, 7.0-23.4 cm). The overall ORRs based on mRECIST and RECIST 1.1 criteria were 94.1% and 51.5%, respectively. The median OS was 28.1 months (95% CI, 22.7-33.4), and the median PFS was 11.7 months (95% CI, 7.7-15.8). All patients experienced AEs, but only 18.4% experienced grade 3 or 4 AEs, there was no treatment-related mortality.

Conclusion: In this single-center, retrospective study, our results suggested that FOLFOX-HAIC with sequential DEB-TACE demonstrated promising efficacy and safety for patients with unresectable HCC with a maximum tumor diameter of ≥7 cm.

基于 FOLFOX 的肝动脉灌注化疗联合序贯药物洗脱珠经动脉化疗栓塞治疗不可切除的大肝细胞癌:一项单中心回顾性队列研究。
背景:对于无法切除的巨大肝细胞癌(HCC)患者,传统的经动脉化疗栓塞术(TACE)的疗效仍不理想,这就需要使用大量的化疗药物和脂肪碘,从而增加了肝衰竭和其他化疗相关并发症的风险。因此,我们设计了一种先进行肝动脉灌注化疗(HAIC),然后再连续进行药物洗脱珠TACE(DEB-TACE)的策略。在我们的治疗设计中,HAIC后较低的肿瘤负荷有利于肿瘤血管的完全栓塞,使用较少的栓塞剂也降低了肝衰竭和栓塞综合征的发生率:这项回顾性研究评估了2019年4月至2024年2月期间连续接受FOLFOX-HAIC联合序贯DEB-TACE治疗的肿瘤最大直径≥7厘米的不可切除的大型HCC患者。疗效通过客观反应率(ORR)、总生存期(OS)和无进展生存期(PFS)进行评估;安全性通过主要不良事件(AEs)的频率进行评估:在纳入的76名患者中,肿瘤最大直径的中位数为12.4厘米(范围为7.0-23.4厘米)。根据mRECIST和RECIST 1.1标准得出的总体ORR分别为94.1%和51.5%。中位OS为28.1个月(95% CI,22.7-33.4),中位PFS为11.7个月(95% CI,7.7-15.8)。所有患者都出现了AEs,但只有18.4%的患者出现了3级或4级AEs,没有治疗相关的死亡率:在这项单中心回顾性研究中,我们的结果表明,FOLFOX-HAIC联合序贯DEB-TACE治疗最大肿瘤直径≥7厘米的不可切除HCC患者具有良好的疗效和安全性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
0.50
自引率
2.40%
发文量
108
审稿时长
16 weeks
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