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Sorafenib in combination with transarterial chemoembolization and radiofrequency ablation in the treatment for unresectable hepatocellular carcinoma

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Abstract

The purpose of this study is to assess clinical efficacy and safety of sorafenib combined with transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) on patients with unresectable hepatocellular carcinoma (HCC). Efficacy and safety profiles of sorafenib in combination with TACE and RFA were evaluated based on retrospective data for thirty patients with unresectable HCC. Patients were treated with TACE initially when admitted to hospital, followed by RFA 3 days after TACE. All TACE and RFA were performed by the same team of doctors. Seven days after the first TACE, patients started taking continuous sorafenib 400 mg bid without breaks until unacceptable toxicities or disease progression. The response to treatment, overall survival (OS), time to progression (TTP), and adverse effects were evaluated. The disease control rate was 33.3 % by RECIST criteria. The median TTP was 15.3 months (95 % CI 4.8–23.5). The median OS was 28.8 months (95 % CI 12.8–39.6). At the time of data record, 13 patients (43.3 %) were dead. Median OS in patients with or without portal vein thrombosis was 12.3 months (95 % CI 7.6–14.5) and 30.2 months (95 % CI 24.2–34.5), respectively, P = 0.018. The most common adverse events related to sorafenib were hand–foot skin reaction (53.3 %) and diarrhea (33.3 %). The combination of sorafenib, TACE, and RFA proved both safe and effective in the treatment for unresectable hepatocellular carcinoma patients.

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References

  1. El-Serag HB, Rudolph KL. Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology. 2007;132:2557–76.

    Article  CAS  PubMed  Google Scholar 

  2. Bruix J, Sherman M. Management of hepatocellular carcinoma: an update. Hepatology. 2011;53:1020–2.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Llovet JM, Bruix J. Systematic review of randomized trials for unresectable hepatocellular carcinoma: Chemoembolization improves survival. Hepatology. 2003;37:429–42.

    Article  CAS  PubMed  Google Scholar 

  4. Llovet JM, Ricci S, Mazzaferro V, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008;359:378–90.

    Article  CAS  PubMed  Google Scholar 

  5. Forner A, Reig ME, de Lope CR, Bruix J. Current strategy for staging and treatment: the BCLC update and future prospects. Semin Liver Dis. 2010;30:61–74.

    Article  CAS  PubMed  Google Scholar 

  6. Lencioni R. Loco-regional treatment of hepatocellular carcinoma. Hepatology. 2010;52:762–73.

    Article  CAS  PubMed  Google Scholar 

  7. Cho YK, Kim JK, Kim MY, Rhim H, Han JK. Systematic review of randomized trials for hepatocellular carcinoma treated with percutaneous ablation therapies. Hepatology. 2009;49:453–9.

    Article  PubMed  Google Scholar 

  8. Ni JY, Liu SS, Xu LF, Sun HL, Chen YT. Transarterial chemoembolization combined with percutaneous radiofrequency ablation versus TACE and PRFA monotherapy in the treatment for hepatocellular carcinoma: a meta-analysis. J Cancer Res Clin Oncol. 2013;139:653–9.

    Article  CAS  PubMed  Google Scholar 

  9. Yan S, Xu D, Sun B. Combination of radiofrequency ablation with transarterial chemoembolization for hepatocellular carcinoma: a meta-analysis. Dig Dis Sci. 2013;58:2107–13.

    Google Scholar 

  10. Carmeliet P, Jain RK. Angiogenesis in cancer and other diseases. Nature. 2000;407:249–57.

    Article  CAS  PubMed  Google Scholar 

  11. Wang B, Xu H, Gao ZQ, Ning HF, Sun YQ, Cao GW. Increased expression of vascular endothelial growth factor in hepatocellular carcinoma after transcatheter arterial chemoembolization. Acta Radiol. 2008;49:523–9.

    Article  CAS  PubMed  Google Scholar 

  12. Xu M, Xie XH, Xie XY, et al. Sorafenib suppresses the rapid progress of hepatocellular carcinoma after insufficient radiofrequency ablation therapy: an experiment in vivo. Acta Radiol. 2013;54:199–204.

    Article  PubMed  Google Scholar 

  13. Cheng AL, Kang YK, Chen Z, et al. Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: a phase III randomised, double-blind, placebo-controlled trial. Lancet Oncol. 2009;10:25–34.

    Article  CAS  PubMed  Google Scholar 

  14. Cho YK, Rhim H, Noh S. Radiofrequency ablation versus surgical resection as primary treatment of hepatocellular carcinoma meeting the Milan criteria: a systematic review. J Gastroenterol Hepatol. 2011;26:1354–60.

    PubMed  Google Scholar 

  15. Han G, Yang J, Shao G, et al. Sorafenib in combination with transarterial chemoembolization in Chinese patients with hepatocellular carcinoma: a subgroup interim analysis of the START trial. Future Oncol. 2013;9:403–10.

    Article  CAS  PubMed  Google Scholar 

  16. Cabrera R, Pannu DS, Caridi J, et al. The combination of sorafenib with transarterial chemoembolisation for hepatocellular carcinoma. Aliment Pharmacol Ther. 2011;34:205–13.

    Article  CAS  PubMed  Google Scholar 

  17. Zhao Y, Wang WJ, Guan S, et al. Sorafenib combined with transarterial chemoembolization for the treatment of advanced hepatocellular carcinoma: a large-scale multicenter study of 222 patients. Ann Oncol. 2013;24:1786–92.

    Google Scholar 

  18. Shibata T, Isoda H, Hirokawa Y, Arizono S, Shimada K, Togashi K. Small hepatocellular carcinoma: is radiofrequency ablation combined with transcatheter arterial chemoembolization more effective than radiofrequency ablation alone for treatment? Radiology. 2009;252:905–13.

    Article  PubMed  Google Scholar 

  19. Zhao M, Wang JP, Li W, et al. Comparison of safety and efficacy for transcatheter arterial chemoembolization alone and plus radiofrequency ablation in the treatment of single branch portal vein tumor thrombus of hepatocellular carcinoma and their prognosis factors. Zhonghua Yi Xue Za Zhi. 2011;91:1167–72.

    PubMed  Google Scholar 

  20. Peng ZW, Chen MS. Transcatheter arterial chemoembolization combined with radiofrequency ablation for the treatment of hepatocellular carcinoma. Oncology-Basel. 2013;84(Suppl 1):40–3.

    Article  CAS  Google Scholar 

  21. Bai W, Wang YJ, Zhao Y, et al. Sorafenib in combination with transarterial chemoembolization improves the survival of patients with unresectable hepatocellular carcinoma: a propensity score matching study. J Dig Dis. 2013;14:181–90.

    Article  CAS  PubMed  Google Scholar 

  22. Svendsen MN, Werther K, Nielsen HJ, Kristjansen PE. VEGF and tumour angiogenesis. Impact of surgery, wound healing, inflammation and blood transfusion. Scand J Gastroenterol. 2002;37:373–9.

    Article  PubMed  Google Scholar 

  23. Li X, Feng GS, Zheng CS, Zhuo CK, Liu X. Expression of plasma vascular endothelial growth factor in patients with hepatocellular carcinoma and effect of transcatheter arterial chemoembolization therapy on plasma vascular endothelial growth factor level. World J Gastroenterol. 2004;10:2878–82.

    CAS  PubMed  Google Scholar 

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Acknowledgments

Science and Technology Foundation of Guangdong Province, China (Grant No. 2011A030400009); Natural Science Foundation of Guangdong Province, China (Grant No. S2012010010569).

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The authors declared no conflict of interests.

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Correspondence to Li-Gong Lu.

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Yong Li, You-Bing Zheng, and Wei Zhao contributed equally to this work.

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Li, Y., Zheng, YB., Zhao, W. et al. Sorafenib in combination with transarterial chemoembolization and radiofrequency ablation in the treatment for unresectable hepatocellular carcinoma. Med Oncol 30, 730 (2013). https://doi.org/10.1007/s12032-013-0730-5

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  • DOI: https://doi.org/10.1007/s12032-013-0730-5

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