A Retrospective Study On Efficacy And Safety Of TACE Combinated With Oral S-1 In The Treatment Of BCLC B Stage Hepatocellular Carcinoma

Purpose:This study aimed at performing a retrospective study comparing TACE alone and in combination with oral S-1 in the treatment of BCLC B stage hepatocellular carcinoma and observing tumor response, TTP and adverse effects. To evaluate whether we can offer a new therapeutic option for patients who suffered from intermediate HCC.Methods: Patients with intermediate HCC in The First Affiliated Hospital of Nanchang University between September 2012 and August 2013 were retrospectively analyzed. Among 54 patients were classified into two groups according to different therapeutic regimens: TACE with oxaliplatin(100-200mg)-THP(20-40mg) plus S-1(oral administration, 40 mg/m2 bid day1–14)(group A),TACE with oxaliplatin(100-200mg)-THP(20-40mg)- fluoropyrimidine(1.0g)(group B). Based on up-to-7 criteria and Child-Pugh score, four sub-stages of Barcelona Clinic Liver Cancer(BCLC) intermediate hepatocellular carcinoma(HCC) were proposed. Thus, patients of both groups were classified into four sub-stages as AB1-AB4 and BB1-BB4. The objective response rate(ORR), disease control rate(DCR) and time to progression(TTP) were evaluated using SPSS 17.0. Meanwhile,the COX proportional hazards model was applied for multivariate analysis of prognostic factors.Results: A total of 54 patients were enrolled in the study, the number of patients in each group was as follows: group A, 25 patients; group B, 29 patients. In the entire population, the ORR and DCR were 59.3% and 85.2%, respectively. The median TTP was 5.9 months. ORR of each group were as follows: group A, 68%; group B, 51.7%;DCR of each group were as follows: group A, 92%; group B, 79.4%; Median TTP times were as follows: group A, 6.8 months; group B, 4.2 months. Patients in group A achieved better ORR and DCR, but neither achieve significant difference(P>0.05).However, Patients in the group A had a significantly longer m TTP than patients in group B(P=0.035). The result of subgroup analyses turned out that patients who exceed Up-to-7 showed a longer m TTP in group A when compared to group B. Thetoxicity was tolerable in both groups. Multivariate analysis showed that tumor response and Up-to-7 were independent prognostic factors of TTP.Conclusion: This study was the first to report the efficacy and safety of TACE in combination with oral S-1 in BCLC B stage hepatocellular carcinoma. The results suggest that the combination therapy has better efficacy and the toxicity was tolerable.The combination group revealed longer TTP in this study. The combination management seems to be an appropriate option for the treatment of patients with intermediate hepatocellular carcinoma, especially whose target lesions exceed Up-to-7.