Combination of sorafenib and TACE inhibits portal vein invasion for intermediate stage HCC: a single center retrospective controlled study

Qi Yao, Hongsen Zhang, Bin Xiong, Chuansheng Zheng, Qi Yao, Hongsen Zhang, Bin Xiong, Chuansheng Zheng

Abstract

Purpose: This study aims to investigate the effect of sorafenib plus Transarterial Chemoembolization (TACE) treatment on inhibiting portal vein invasion in patients with intermediate stage HCC.

Materials and methods: The consecutive medical records of patients with HCC were retrospectively analyzed from October 2009 to February 2015. The propensity score matching method was applied into group matching. The Kaplan-Meier method and the Log-Rank Test was used to estimate the median survival time, median time to progression and median time to portal vein invasion. Factors associated with survival benefits were identified by univariate and multivariate Cox-regression model analyses.

Results: Of 97 patients enrolled, 19 patients received TACE-sorafenib treatment and 78 patients received TACE treatment. During the follow-up period of 15 months, the median time to portal vein invasion was 14.2 months vs 8.77 months, respectively (p=0.073). And the analysis of the cox's proportional hazard model revealed that patients treated with TACE treatment alone would run greater risk of portal vein invasion compared with TACE-sorafenib treatment (hr=7.49, p=0.021). Early administration of sorafenib was associated with lower risk of portal vein invasion (p=0.021) according to the univariate analysis. Adverse events (AEs) identified in the combined group were mostly classified as Grades 1 and 2, and skin-related reactions and fatigue were the most common.

Conclusions: Sorafenib may could inhibit portal vein invasion of hepatoma carcinoma cells. Early administration of sorafenib may bring more survival benefits.

Keywords: combined therapy; hepatocellular carcinoma (HCC); portal vein invasion; sorafenib; transcatheter arterial chemoembolization (TACE).

Figures

Figure 1. Propensity score matching was used…
Figure 1. Propensity score matching was used and was included as independent variable into a COX model, and no significant difference was showed in baseline data (p=0. 382, hr=1.55)
Figure 2. Survival curve of the two…
Figure 2. Survival curve of the two group was drawed by Kaplan-Meier method, median time to portal vein invasion of the two group showed no significant differences (TACE-sorafenib vs TACE, 34 months vs 36 months, p=0. 327)
Figure 3. During the follow-up period of…
Figure 3. During the follow-up period of 15 months, after propensity score matching, the hazard of portal vein invasion of the TACE monotherapy was higher than the TACE-sorafenib group (hr=7.49, p=0.021)
Figure 4. The OS curve of the…
Figure 4. The OS curve of the two group--the TACE plus sorafenib group, n=19, median OS is 23 months, the TACE group, n=78, median OS is 13.8 months and no significant differences was showed (p=0.061)
Figure 5. TTP curve of the two…
Figure 5. TTP curve of the two group-- the median TTP showed no significant differences (TACE-sorafenib vs TACE, 10 months vs 8.8 months, p=0.061)
Figure 6
Figure 6
Univariate analyses revealed that the early administation of sorafenib was significantly associated with better OS—(a), the box-plot of tumor size (p=0. 027); (b), the box-plot of time to start administration of sorafenib (p=0.021).

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