The Efficacy Of Transarterial Chemoembolization Combined With Sorafenib In Advanced Hepatocellular Carcinoma

Objective: Currently, it is widely known that one of the m OSt commonmeasures treated advanced hepatocellular carcinoma is transarterialchemoembolization(TACE). But this measure can lead to the tissue ischemiaand hypoxia. In the environment, vascular endothelial growth factor issecreted and lead to the tumor occur metastasis. Sorafenib is considered as thefirst molecular targeted drugs witch has confirmed by numbers of trials to treatadvanced hepatocellular carcinoma. It can inhibit tumor-cell proliferation andtumor angiogenesis.For the advanced hepatocellular carcinoma patients, the efficacy ofsorafenib and TACE have been recogniced by many researchers. However,wheather the combination therapy can achieve amazing efficacy or not, andthe patients derive greater clinical benefit. Currently, studies show differentresults, so it is necessary to evaluate the clinical efficacy again.Materials and Methords: 298 patients with advanced hepatocellularcarcinoma of the fourth Hm OSpital of Hebei Medical University from January2008 to December 2014 were assigned. And the medical record dateconcluded of the BCLC staging, Child-Pugh, Hepatitis type, Antiretrovivaltherapy or not, imaging evaluation, AFP level and liver function and so on.Primary outcomes were meidian overall survival(m OS), the median time tosymptomatic progression(m TTP). Kaplan-Meier methord were used tocalculate the survial time and plot the survial curves. Besides, log-rankmearsure were utilized to compare between different groups.Results:1 The median overall survial of the hepatocellular carcinoma patients was13 months(95% confidence interval:11.147 to 14.853), the median time tosymptomatic progression was 5.5 months(95% confidence interval:4.818 to6.182).2 The median overall survial of the 89 patients who had sorafenib was 10months(95%confidence interval: 7.734-12.266), the m TTP of the 80 patientwas 6 months(95%confidence interval:5.527-6.473). Patients with BCLCstage earlier, TNM earlier, without PVTT, without metastasis had longerm OS.Cox proportional hazard regression model showed that BCLC was thesignificant prognm OStic factors of m OS.3 Median overall survival of the patient who accepted the antiretroviraltherapy was 7 months and 11.5 months in the other therapy(P=0.442).Therewas also no significant difference between the two measures(sorafenibcombined with antiretroviral therapy or not) of the median time tosymptomatic progression(8 months vs.6 months,P=0.429).4 Median overall survival was 13 months in the joint group and 8 monthsin the sorafenib group(P=0.002), and the median time to symptomaticprogression was 6 months in the joint group and 6 months in the sorafenibgroup(P=0.000). It showed that whether the patient’s general condition score,with metastasis or not, the level of the AFP, with metastasis, TNM-Ⅲ stage,BCLC-C stage, the Median overall survival of joint group was longer thansorafenib group.5 Median overall survival was 13 months in the joint group and 15 months in the TACE group(P=0.836), and the median time to symptomaticprogression was 9 months in the joint group and 5 months in the TACE group(P=0.004). It showed that whether the patient’s general condition score, withPVTT or not, with metastasis or not, TNM stage, the level of the AFP, thelower level of TBIL and BCLC-C stage, the median time to symptomaticprogression of joint group was longer than sorafenib group.Conclusons:1 Sorafenib treated advanced hepatocellular carcinoma was effective.Without of PVTT, without of metastasis and earlier BCLC-stage of thepatients had batter efficacy. For overall survial, BCLC-stage was the onlyindependent prognm OStic factor. All of this indicated that the earlier appliedthe sorafenib,the more efficacy of the patients got. And the earlierBCLC-stage of the patients had batter prognm OSis.2 Comparing with monotherapy, combination therapy had better efficacy,and the long-term efficacy of combination therapy was superior to TACE.