Abstract
The aim of the present study was to compare the effectiveness of transarterial chemoembolization (TACE), TACE combined with Jie-du granules (JD), and TACE combined with sorafenib (SOR) for treating patients with unresectable hepatocellular carcinoma (HCC). For this purpose, we conducted a retrospective analysis of data from 266 consecutive patients with unresectable HCC who underwent TACE treatment at the Shanghai Hospital and Eastern Hepatic Surgery Hospital between Jan 2009 and Dec 2010. We prospectively analyzed patient survival and progression times as well as independent predictors, within a follow-up period of 86 months. Patients were divided into TACE-JD (n = 75), TACE-SOR (n = 124) and TACE (n = 67) groups. Median overall survival (OS) times being: TACE-JD, 21.43 months; TACE-SOR, 23.23 months; TACE, 13.97 months (TACE-SOR vs TACE, P < 0.001; TACE-SOR vs TACE-JD, P = 0.852; TACE-JD vs TACE, P < 0.001). The median times to progression (TTP) were as follows: TACE-JD, 8.67 months; TACE-SOR, 5.37 months; TACE, 4.57 months (TACE-SOR vs TACE, P = 0.479; TACE-SOR vs TACE-JD, P < 0.001; TACE-JD vs TACE, P < 0.001). Independent predictors of OS were treatment allocation, Child-Pugh class large tumor, albumin and extrahepatic metastasis. These findings show that patients with unresectable HCC who were administered TACE-JD survived significantly longer compared with those administered TACE or TACE-SOR.
Highlights
Hepatocellular carcinoma (HCC) is the sixth most common cancer and second leading cause of cancerrelated death worldwide [1,2]
The aim of the present study was to compare the effectiveness of transarterial chemoembolization (TACE), TACE combined with Jie-du granules (JD), and TACE combined with sorafenib (SOR) for treating patients with unresectable hepatocellular carcinoma (HCC)
Independent predictors of overall survival (OS) were treatment allocation, Child-Pugh class large tumor, albumin and extrahepatic metastasis. These findings show that patients with unresectable HCC who were administered TACE plus JD (TACE-JD) survived significantly longer compared with those administered TACE or TACE-SOR
Summary
Hepatocellular carcinoma (HCC) is the sixth most common cancer and second leading cause of cancerrelated death worldwide [1,2]. TACE combined with other treatments may improve the outcomes of patients with unresectable HCC. Bevacizumab [5], sorafenib [6], and arsenic trioxide [7] combined with TACE can prolong the survival of patients with HCC. A meta-analysis found that TACE plus sorafenib (TACE-SOR) administered to patients with intermediate or advanced HCC improved overall survival (OS), time to progression (TTP), and the overall response rate [8,9,10,11,12]. A phase III randomized controlled trial found that that TACE-SOR did not clinically improve TTP compared with TACE in patients with intermediate www.impactjournals.com/oncotarget stage multinodular HCC and that the time to unTACEable progression (TTUP) was lower for patients administered sorafenib compared with those given placebo [8]
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