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Sorafenib in combination with transarterial chemoembolization improves the survival of patients with unresectable hepatocellular carcinoma: A propensity score matching study
Author(s) -
Bai Wei,
Wang Yong Ji,
Zhao Yan,
Qi Xing Shun,
Yin Zhan Xin,
He Chuang Ye,
Li Rui Jun,
Wu Kai Chun,
Xia Jie Lai,
Fan Dai Ming,
Han Guo Hong
Publication year - 2013
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12038
Subject(s) - medicine , sorafenib , hepatocellular carcinoma , propensity score matching , hazard ratio , gastroenterology , oncology , adverse effect , proportional hazards model , transcatheter arterial chemoembolization , randomized controlled trial , confidence interval
Objective This prospective non‐randomized controlled trial aimed to compare the efficacy of sorafenib in combination with transarterial chemoembolization ( TACE ) vs TACE alone for the treatment of patients with unresectable intermediate or advanced hepatocellular carcinoma. Methods A total of 304 patients were enrolled, in which 82 received concurrent sorafenib (400 mg orally twice daily, initiated within 14 days after TACE ), and these patients were matched with 164 patients who received TACE alone at a 1:2 ratio using propensity score matching to minimize selection bias. The response to treatment, time‐to‐progression ( TTP ), overall survival ( OS ) as well as adverse events were compared between the two groups.Results During a median follow‐up period of 21.4 weeks (range 0.5–103 weeks), the addition of sorafenib prolonged TTP (6.3 vs 4.3 months; hazard ratio [ HR ] 0.60, 95% CI 0.422–0.853, P = 0.004) and median survival (7.5 vs 5.1 months; HR 0.61, 95% CI 0.423–0.884, P = 0.009) compared with TACE alone. Significant prognostic factors for OS by multivariate analysis included the use of sorafenib, Barcelona Clinic Liver Cancer stage, metastasis/vascular invasion and C hild‐ P ugh score. Conclusions The combined use of sorafenib and TACE was generally well tolerated and significantly improved OS and TTP compared with TACE alone in patients with intermediate or advanced HCC. Further studies are warranted to confirm the safety and efficacy of this combination therapy.