Abstract
Background
We compared the clinical efficacies of hepatic arterial infusion chemotherapy (HAIC) vs. sorafenib as sequential maintenance therapy following liver-directed concurrent chemoradiotherapy (LD-CCRT) for locally advanced-stage hepatocellular carcinoma (HCC).
Methods
Patients undergoing HAIC with 5-fluorouracil and cisplatin (HAIC-maintain group, n = 151) or sorafenib (Sorafenib-maintain group, n = 37) after LD-CCRT were consecutively enrolled. The study endpoints were overall survival (OS), progression-free survival (PFS), and treatment response rates.
Results
The median OS among HAIC-maintain and Sorafenib-maintain groups were 15.9 and 24.3 months (p = 0.287), whereas the median PFS were 8.1 and 9.1 months (p = 0.651), respectively. During the planned treatments, the radiological objective response rate (54.3% vs. 64.9%; p = 0.246), and conversion rate to surgical resection or liver transplantation after successful down-staging (15.9% vs. 18.9%; p = 0.657) were comparable between the HAIC-maintain and Sorafenib-maintain groups. Similar results were found after the inverse probability of treatment weighting and propensity score-matching analyses. Regarding treatment-related adverse events, the HAIC-maintain group showed worse profiles in terms of leukopenia (all grades [p = 0.001] and grades 3 or 4 [p = 0.041]) and hypoalbuminemia (p = 0.001) than the Sorafenib-maintain group.
Conclusions
The overall clinical efficacies between the sequential treatment of HAIC vs. sorafenib after LD-CCRT were comparable for locally advanced HCC.
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Data availability
The datasets generated and analyzed during the current study are not publicly available due to the IRB guidelines but are available from the corresponding author on reasonable request.
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Conceptualization, SH. and BKK.; methodology, SH, HWL, and BKK, and software, SH, HRK, HL, JSL, HWL, and SUK; validation, SH, JYP, and BKK; formal analysis, SH, HRK, HL, JSL, and DYK; investigation, SH, HWL, and DYK; resources, BKK; data curation, SH, HL, and JSL; writing—original draft preparation, SH, JYW, SUK, JYP, DYK and BKK; writing—review and editing, SH, HJC, SB, HL, JSL SHA, KHH, JS and BKK.; visualization, SH, JYP, and SHA; supervision, BKK; All authors have read and agreed to the published version of the manuscript.
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This study protocol was developed in accordance with the ethical guidelines of the 1975 Declaration of Helsinki and approved by the Institutional Review Board of our institute (No. 4–2020-0145). The requirement for written informed consent was waived owing to the retrospective design.
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Han, S., Choi, H.J., Beom, SH. et al. Treatment efficacy by hepatic arterial infusion chemotherapy vs. sorafenib after liver-directed concurrent chemoradiotherapy for advanced hepatocellular carcinoma. J Cancer Res Clin Oncol 147, 3123–3133 (2021). https://doi.org/10.1007/s00432-021-03632-4
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DOI: https://doi.org/10.1007/s00432-021-03632-4