Chung-Wei Liu, Po-Ting Lin, Wei Teng, Wei-Ting Chen, Chung-Wei Su, Yi-Chung Hsieh, Chen-Chun Lin, Chun-Yen Lin, Shi-Ming Lin
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Kaplan-Meier analysis, Cox proportional hazards models, and propensity score matching were applied.</p><p><strong>Results: </strong>Among 130 patients, the combination therapy group showed significantly improved overall survival (OS) (20.2 versus 11.8 months, <i>p</i> = 0.000) and progression-free survival (PFS) (8.2 versus 3.6 months, <i>p</i> = 0.011) compared to the HAIC-only group. These advantages persisted after propensity score matching with improved OS (20.2 vs 12.9 months, <i>p</i> = 0.001) and extrahepatic PFS (12.4 vs 5.5 months, <i>p</i> = 0.008). Combination therapy improved PFS in the stage IV portal vein thrombosis (PVT) subgroup. TKI combination therapy, more than nine HAIC cycles, and post-HAIC transarterial chemoembolization (TACE) were independent predictors of improved OS.</p><p><strong>Conclusion: </strong>Combining HAIC with TKI therapy improves survival outcomes compared to HAIC alone in patients with unresectable HCC, especially in cases with extrahepatic spread and PVT. Sequential TACE following HAIC therapy further enhances survival benefits.</p>","PeriodicalId":15906,"journal":{"name":"Journal of Hepatocellular Carcinoma","volume":"12 ","pages":"1017-1029"},"PeriodicalIF":4.2000,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103852/pdf/","citationCount":"0","resultStr":"{\"title\":\"Combination of Hepatic Arterial Infusion Chemotherapy with Tyrosine Kinase Inhibitor Provides Better Survival in Advanced Hepatocellular Carcinoma Patients.\",\"authors\":\"Chung-Wei Liu, Po-Ting Lin, Wei Teng, Wei-Ting Chen, Chung-Wei Su, Yi-Chung Hsieh, Chen-Chun Lin, Chun-Yen Lin, Shi-Ming Lin\",\"doi\":\"10.2147/JHC.S502922\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Hepatic arterial infusion chemotherapy (HAIC) and tyrosine kinase inhibitors (TKI) are widely used to treat unresectable hepatocellular carcinoma (HCC). This study investigated the benefits of combining TKI and HAIC in these patients.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with unresectable HCC treated at Linkou Chang Gung Memorial Hospital between March 2009 and February 2022. The patients were categorized into two groups: HAIC combined with TKI therapy and HAIC alone. Kaplan-Meier analysis, Cox proportional hazards models, and propensity score matching were applied.</p><p><strong>Results: </strong>Among 130 patients, the combination therapy group showed significantly improved overall survival (OS) (20.2 versus 11.8 months, <i>p</i> = 0.000) and progression-free survival (PFS) (8.2 versus 3.6 months, <i>p</i> = 0.011) compared to the HAIC-only group. These advantages persisted after propensity score matching with improved OS (20.2 vs 12.9 months, <i>p</i> = 0.001) and extrahepatic PFS (12.4 vs 5.5 months, <i>p</i> = 0.008). Combination therapy improved PFS in the stage IV portal vein thrombosis (PVT) subgroup. TKI combination therapy, more than nine HAIC cycles, and post-HAIC transarterial chemoembolization (TACE) were independent predictors of improved OS.</p><p><strong>Conclusion: </strong>Combining HAIC with TKI therapy improves survival outcomes compared to HAIC alone in patients with unresectable HCC, especially in cases with extrahepatic spread and PVT. 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引用次数: 0
摘要
肝动脉输注化疗(HAIC)和酪氨酸激酶抑制剂(TKI)被广泛用于治疗不可切除的肝细胞癌(HCC)。本研究调查了TKI和HAIC联合治疗这些患者的益处。方法:回顾性分析2009年3月至2022年2月在林口长庚纪念医院治疗的不可切除HCC患者。患者分为两组:HAIC联合TKI治疗和HAIC单独治疗。应用Kaplan-Meier分析、Cox比例风险模型和倾向评分匹配。结果:在130例患者中,联合治疗组与haic组相比,总生存期(OS)(20.2个月对11.8个月,p = 0.000)和无进展生存期(PFS)(8.2个月对3.6个月,p = 0.011)显着提高。在倾向评分与改善的OS (20.2 vs 12.9个月,p = 0.001)和肝外PFS (12.4 vs 5.5个月,p = 0.008)匹配后,这些优势仍然存在。联合治疗可改善IV期门静脉血栓亚组的PFS。TKI联合治疗、超过9个HAIC周期和HAIC后经动脉化疗栓塞(TACE)是改善OS的独立预测因素。结论:与单用HAIC治疗相比,HAIC联合TKI治疗可改善不可切除HCC患者的生存结果,特别是在肝外扩散和ppt的病例中。在HAIC治疗后序贯TACE治疗可进一步提高生存获益。
Combination of Hepatic Arterial Infusion Chemotherapy with Tyrosine Kinase Inhibitor Provides Better Survival in Advanced Hepatocellular Carcinoma Patients.
Introduction: Hepatic arterial infusion chemotherapy (HAIC) and tyrosine kinase inhibitors (TKI) are widely used to treat unresectable hepatocellular carcinoma (HCC). This study investigated the benefits of combining TKI and HAIC in these patients.
Methods: We retrospectively analyzed patients with unresectable HCC treated at Linkou Chang Gung Memorial Hospital between March 2009 and February 2022. The patients were categorized into two groups: HAIC combined with TKI therapy and HAIC alone. Kaplan-Meier analysis, Cox proportional hazards models, and propensity score matching were applied.
Results: Among 130 patients, the combination therapy group showed significantly improved overall survival (OS) (20.2 versus 11.8 months, p = 0.000) and progression-free survival (PFS) (8.2 versus 3.6 months, p = 0.011) compared to the HAIC-only group. These advantages persisted after propensity score matching with improved OS (20.2 vs 12.9 months, p = 0.001) and extrahepatic PFS (12.4 vs 5.5 months, p = 0.008). Combination therapy improved PFS in the stage IV portal vein thrombosis (PVT) subgroup. TKI combination therapy, more than nine HAIC cycles, and post-HAIC transarterial chemoembolization (TACE) were independent predictors of improved OS.
Conclusion: Combining HAIC with TKI therapy improves survival outcomes compared to HAIC alone in patients with unresectable HCC, especially in cases with extrahepatic spread and PVT. Sequential TACE following HAIC therapy further enhances survival benefits.