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Lenvatinib plus drug-eluting bead transarterial chemoembolization with/without hepatic arterial infusion chemotherapy for hepatocellular carcinoma larger than 7 cm with major portal vein tumor thrombosis: a multicenter retrospective cohort study.
Cai, Mingyue; Liang, Licong; Zhang, Jian; Chen, Nianping; Huang, Wensou; Guo, Yongjian; Hong, Xiaotao; Lin, Liteng; Liu, Yaohong; Dan, Cao; Deng, Haihui; Liu, Xiaoguang; Zhou, Jingwen; Chen, Ye; Chen, Huanwei; Zhu, Kangshun.
Afiliación
  • Cai M; Department of Minimally Invasive Interventional Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
  • Liang L; Department of Minimally Invasive Interventional Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
  • Zhang J; Department of Interventional Medicine, Zhongshan City People's Hospital, Zhongshan, China.
  • Chen N; Department of Hepatobiliary and Pancreatic Surgery, Affiliate Hospital of Guangdong Medical University, Zhanjiang, China.
  • Huang W; Department of Minimally Invasive Interventional Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
  • Guo Y; Department of Minimally Invasive Interventional Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
  • Hong X; Department II of Oncology, Jieyang People's Hospital, Jieyang, China.
  • Lin L; Department of Minimally Invasive Interventional Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
  • Liu Y; Department of Vascular and Interventional Radiology, Huizhou Municipal Central Hospital, Huizhou, China.
  • Dan C; Department of General Surgery, Guangzhou Development District Hospital, Guangzhou, China.
  • Deng H; Department of Interventional Radiology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China.
  • Liu X; Department of Hepatobiliary and Pancreatic Surgery, Affiliate Hospital of Guangdong Medical University, Zhanjiang, China.
  • Zhou J; Department of Minimally Invasive Interventional Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
  • Chen Y; Department of Minimally Invasive Interventional Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
  • Chen H; Department of Hepatopancreatic Surgery, the First People's Hospital of Foshan, Foshan, China.
  • Zhu K; Department of Minimally Invasive Interventional Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Int J Surg ; 2024 Jun 13.
Article en En | MEDLINE | ID: mdl-38869974
ABSTRACT

BACKGROUND:

The management of hepatocellular carcinoma (HCC) with high tumor burden and major portal vein tumor thrombosis (PVTT) remains a great challenge. We aimed to investigate the efficacy and safety of lenvatinib plus drug-eluting bead transarterial chemoembolization (DEB-TACE) and hepatic arterial infusion chemotherapy (HAIC) with oxaliplatin, fluorouracil and leucovorin (Len+DEB-TACE+HAIC) versus lenvatinib plus DEB-TACE (Len+DEB-TACE) for HCC > 7.0 cm accompanied with major PVTT. MATERIALS AND

METHODS:

This multicenter retrospective cohort study evaluated consecutive patients with HCC (> 7.0 cm) and major PVTT who received Len+DEB-TACE+HAIC (Len+DEB-TACE+HAIC group) or Len+DEB-TACE (Len+DEB-TACE group) between July 2019 and June 2021 from eight institutions in China. Objective response rate (ORR), time to progression (TTP), overall survival (OS), and treatment-related adverse events (TRAEs) were compared between the two groups by propensity score-matching (PSM).

RESULTS:

A total of 205 patients were included. After PSM, 85-paired patients remained in the study cohorts. Patients in the Len+DEB-TACE+HAIC group had higher ORR (61.2% vs. 34.1%, P < 0.001), longer TTP (median, 9.8 vs. 5.9 months, P < 0.001), and prolonged OS (median, 16.7 vs. 12.5 months, P < 0.001) than those in the Len+DEB-TACE group. The ORR and TTP of both intrahepatic tumor (ORR 64.7% vs. 36.5%, P < 0.001; median TTP 10.7 vs. 7.0 months, P < 0.001) and PVTT (ORR 74.1% vs. 47.1%, P < 0.001; median TTP 17.4 vs. 7.6 months, P < 0.001) were better in the Len+DEB-TACE+HAIC group than the Len+DEB-TACE group. The frequency of grade 3-4 TRAEs in the Len+DEB-TACE+HAIC group were comparable to those in the Len+DEB-TACE group (38.8% vs. 34.1%, P = 0.524).

CONCLUSION:

The addition of HAIC to Len+DEB-TACE significantly improved ORR, TTP, and OS over Len+DEB-TACE with an acceptable safety profile for large HCC with major PVTT.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Int J Surg Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Int J Surg Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Estados Unidos