Clin Mol Hepatol.  2017 Jun;23(2):128-137. 10.3350/cmh.2016.0071.

A comparative study of sorafenib and metronomic chemotherapy for Barcelona Clinic Liver Cancer-stage C hepatocellular carcinoma with poor liver function

• Yang H
• Woo HY
• Lee SK
• Han JW
• Jang B
• Nam HC
• Lee HL
• Lee SW
• Song DS
• Song MJ
• Oh JS
• Chun HJ
• Jang JW
• Lozada A
• Bae SH
• Choi JY
• Yoon SK

• KMID: 2413116
• DOI: http://doi.org/10.3350/cmh.2016.0071

Abstract

BACKGROUND/AIMS
Metronomic chemotherapy (MET) is frequently administered in comparatively low doses as a continuous chemotherapeutic agent. The aim of this study was to evaluate the feasibility and overall survival (OS) of MET compared to sorafenib for advanced hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT).
METHODS
A total of 54 patients with advanced HCC and PVTT who had undergone MET were analyzed between 2005 and 2013. A total of 53 patients who had undergone sorafenib therapy were analyzed as the control group. The primary endpoint of this study was OS.
RESULTS
The median number of MET cycles was two (1-15). The OS values for the MET group and sorafenib group were 158 days (132-184) and 117 days (92-142), respectively (P=0.029). The Cox proportional-hazard model showed that a higher risk of death was correlated with higher serum alpha fetoprotein level (≥400 mg/dL, hazard ratio [HR]=1.680, P=0.014) and Child-Pugh class B (HR=1.856, P=0.008).
CONCLUSIONS
MET was associated with more favorable outcomes in terms of overall survival than was sorafenib in patients with advanced HCC with PVTT, especially in patients with poor liver function. Therefore, MET can be considered as a treatment option in patients with advanced HCC with PVTT and poor liver function.

Keyword

Carcinoma, Hepatocellular; Administration, Metronomic; Portal vein; Sorafenib; Thrombosis

MeSH Terms

Adult
Aged
Antineoplastic Agents/adverse effects/*therapeutic use
Carcinoma, Hepatocellular/*drug therapy/mortality/pathology
Cisplatin/adverse effects/therapeutic use
Drug Administration Schedule
Female
Fluorouracil/adverse effects/therapeutic use
Humans
Hyperbilirubinemia/etiology
Liver/pathology
Liver Neoplasms/*drug therapy/mortality/pathology
Male
Middle Aged
Neoplasm Staging
Niacinamide/adverse effects/*analogs & derivatives/therapeutic use
Phenylurea Compounds/adverse effects/*therapeutic use
Retrospective Studies
Thrombocytopenia/etiology
Treatment Outcome
Venous Thrombosis/complications/diagnosis
alpha-Fetoproteins/analysis
Antineoplastic Agents
Phenylurea Compounds
alpha-Fetoprotein
Niacinamide
Cisplatin
Fluorouracil