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  • Title: Efficacy of transcatheter arterial chemoembolization followed by sorafenib for intermediate/advanced hepatocellular carcinoma in patients in Japan: a retrospective analysis.
    Author: Ohki T, Sato K, Yamagami M, Ito D, Yamada T, Kawanishi K, Kojima K, Seki M, Toda N, Tagawa K.
    Journal: Clin Drug Investig; 2015 Nov; 35(11):751-9. PubMed ID: 26446004.
    Abstract:
    BACKGROUND: Sorafenib might prevent hepatocellular carcinoma (HCC) recurrence caused by the promotion of neoangiogenesis after transarterial chemoembolization (TACE). OBJECTIVES: To evaluate the efficacy and safety of TACE followed by sorafenib for treating advanced HCC. PATIENTS AND METHODS: We retrospectively analyzed 95 advanced HCC patients treated with TACE between July 2008 and December 2012 at our institution. Twenty-four patients received TACE followed by sorafenib within 14 days (S-TACE) and 71 received TACE alone. Progression-free survival (PFS) and cumulative survival from the time of non-responsiveness to TACE were compared between groups and predictive factors for PFS were analyzed. RESULTS: The median patient age was 72.2 years and 74 patients were male (77.9 %). Although median tumor size was similar between groups, the mean tumor number was significantly higher in the S-TACE versus TACE-alone group (16 vs. 8, P = 0.04). The number of prior treatments was significantly higher in the S-TACE group. Other baseline variables were similar. There were two severe adverse events in the S-TACE group and none in the TACE-alone group. Median PFS (189 vs. 106 days, P = 0.02) and median overall survival time (861 vs. 467 days, P = 0.01) from the time of non-responsiveness to TACE were significantly longer with S-TACE than TACE alone. Adjusting for significant factors in univariate analysis, multivariate analysis indicated that sorafenib administration, tumor size, and alanine transaminase were independent predictors of PFS. CONCLUSION: TACE followed by sorafenib significantly improved PFS and survival in patients with advanced HCC unresponsive to TACE.
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