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Role of lamivudine with transarterial chemoembolization in the survival of patients with hepatocellular carcinoma
Author(s) -
Xu Xiaojing,
Huang Peixin,
Tian Hui,
Chen Yi,
Ge Ningling,
Tang Wengquing,
Yang Biwei,
Xia Jinglin
Publication year - 2014
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12554
Subject(s) - lamivudine , medicine , hepatocellular carcinoma , gastroenterology , hazard ratio , proportional hazards model , hepatitis b virus , hepatitis b , oncology , immunology , virus , confidence interval
Background and Aim The purpose of the present study was to determine whether lamivudine in combination with transarterial chemoembolization ( TACE ) could reduce hepatitis B virus ( HBV ) activation and improve the survival of patients with hepatocellular carcinoma ( HCC ). Methods From J uly 2008 to O ctober 2011, a total of 181 consecutive HBV ‐related HCC patients undergoing TACE were randomized to two groups (92: lamivudine, 89: control). Follow up was every 3 months. Primary and secondary end‐points were time to progression ( TTP ) and overall survival ( OS ), respectively, both of which were evaluated by the Kaplan–Meier technique and summarized by the hazard ratio. Results The level of HBV‐DNA became undetectable in 42 (45.6%) patients in the lamivudine group, compared with 10 (11.2%) in the control group ( P < 0.001). The median TTP was 8.2 months in lamivudine group and 4.3 months in control group ( P = 0.005), and lamivudine therapy was an independent protective factor related to TTP ( P = 0.006). Moreover, 1‐, 2‐, and 3‐year survival rates were 83%, 69%, and 58% in lamivudine group and 60%, 48%, and 48% in control group, respectively ( P = 0.002). With multivariate Cox regression model, lamivudine therapy ( P = 0.002) and α‐fetoprotein ( AFP ) level ( P = 0.003) were two independent predictors for OS . Conclusion Lamivudine therapy could reduce HBV activation and improve survival of HCC patients treated with TACE . Lamivudine therapy and AFP level are two independent factors affecting OS .