Efficacy And Safety Of Raltitrexed-based Transcatheter Arterial Chemoembolization For Intermediate And Advanced Hepatocellular Carcinoma Through Real-world Study

Objective: This study aimed to evaluate efficacy and safety of raltitrexed-based transcatheter arterial chemoembolization(TACE)for intermediate and advanced hepatocellular carcinoma(HCC)through real-world study.Methods: All eligible HCC cases were collected from January 2013 to December 2018 in Chongqing,and divided them into two groups according to whether they use raltitrexed or not.The 1:1 proportion of propensity score matching(PSM)was used to eliminate the imbalance of potential confounding factors between groups,and 89 pairs were successfully matched.The overall survival(OS)and progression-free survival(PFS)were analyzed by Kaplan-Meier method and the prognostic factors were analyzed by Cox regression model.Results: The median follow-up period for patients in the raltitrexed group and control group were 8.7 months and 5.9 months,respectively.After PSM,The median OS were 10.0 months(95% CI: 8.2-11.8)in the raltitrexed group and 8.1 months(95% CI: 7.2-8.9)in the control group(P= 0.002).The half-year,1-year and 2-year OS rates of the raltitrexed group were significantly higher than those of the control group(79.8% vs 64.0%,P = 0.002;41.5% vs 27.0%,P = 0.040;14.6% vs 5.6%,P = 0.047;respectively).Multivariate analysis of these propensity score-matched HCC patients revealed the treatment,tumor size and number of TACE as independent predictors of OS(all P < 0.05).The tumor control rate of raltitrexed group and control group was 87.4% and 65.8% respectively(P <0.001).There was no significant difference in the total number of patients who experienced or reported adverse events(AEs)of grade 3/4(G3/4)between the two groups.There was no treatment-related death during treatment.Conclusion: Raltitrexed-based TACE can prolong OS of patients with for intermediate and advanced HCC in a real-world clinical setting,and is safe and tolerable.