Combination of transcatheter arterial chemoembolization and interrupted dosing sorafenib improves patient survival in early–intermediate stage hepatocellular carcinoma: A post hoc analysis of the START trial

The survival benefit of treatment for unresectable hepatocellular carcinoma (HCC) with transcatheter arterial chemoembolization (TACE) combined with sorafenib remains uncertain. We compared the survival of patients treated with TACE and sorafenib with that of patients treated with TACE alone. This w...

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Bibliographic Details
Published in:Medicine (Baltimore) 2017-09, Vol.96 (37), p.e7655-e7655
Main Authors: Lee, Teng-Yu, Lin, Chen-Chun, Chen, Chiung-Yu, Wang, Tsang-En, Lo, Gin-Ho, Chang, Chi-Sen, Chao, Yee
Format: Article
Language:English
Subjects:
Aged
Antineoplastic Agents - administration & dosage
Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - therapy
Chemoembolization, Therapeutic - methods
Clinical Trial/Experimental Study
Combined Modality Therapy
Drug Administration Schedule
Female
Humans
Liver Neoplasms - pathology
Liver Neoplasms - therapy
Male
Middle Aged
Multivariate Analysis
Neoplasm Staging
Niacinamide - administration & dosage
Niacinamide - analogs & derivatives
Phenylurea Compounds - administration & dosage
Proportional Hazards Models
Regression Analysis
Sorafenib
Survival Analysis
Taiwan
Treatment Outcome
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Summary:The survival benefit of treatment for unresectable hepatocellular carcinoma (HCC) with transcatheter arterial chemoembolization (TACE) combined with sorafenib remains uncertain. We compared the survival of patients treated with TACE and sorafenib with that of patients treated with TACE alone. This was a post hoc analysis of the Study in Asia of the Combination of TACE with Sorafenib in Patients with HCC (START) trial. All patients who received TACE and interrupted dosing of sorafenib for early or intermediate-stage HCC in Taiwan from 2009 to 2010 were recruited into the TACE and sorafenib group. They were randomly matched 1:1 by age, sex, Child-Pugh score, tumor size, tumor number, and tumor stage with patients from Taichung Veterans General Hospital in Taiwan who received TACE alone and who fulfilled the selection criteria of the START trial during the same time period (control group). Patient survival [cumulative incidence and hazard ratio (HR)] of the 2 groups were analyzed and compared. The baseline characteristics of the 36 patients in each group were similar. Tumor response rates were significantly better in the TACE and sorafenib group (P 
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000007655