EASL- and mRECIST-Evaluated Responses to Combination Therapy of Sorafenib with Transarterial Chemoembolization Predict Survival in Patients with Hepatocellular Carcinoma

被引:30
|
作者
Liu, Lei [1 ]
Wang, Weijuan [1 ]
Chen, Hui [1 ]
Zhao, Yan [1 ]
Bai, Wei [1 ]
Yin, Zhanxin [1 ]
He, Chuangye [1 ]
Jia, Jia [1 ]
Yang, Man [1 ]
Xia, Jielai [2 ]
Fan, Daiming [3 ,4 ]
Han, Guohong [1 ]
机构
[1] Fourth Mil Med Univ, Xijing Hosp, Dept Liver Dis & Digest Intervent Radiol, Xijing Hosp Digest Dis, Xian 710032, Peoples R China
[2] Fourth Mil Med Univ, Xijing Hosp, Dept Med Stat, Xian 710032, Peoples R China
[3] Fourth Mil Med Univ, Xijing Hosp, State Key Lab Canc Biol, Xian 710032, Peoples R China
[4] Fourth Mil Med Univ, Xijing Hosp, Xijing Hosp Digest Dis, Xian 710032, Peoples R China
关键词
TUMOR RESPONSE; LOCOREGIONAL THERAPY; EVALUATION CRITERIA; MODIFIED RECIST; PHASE-II;
D O I
10.1158/1078-0432.CCR-13-1716
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: Published studies have not investigated the suitability of Response Evaluation Criteria in Solid Tumors (RECIST), European Association for the Study of the Liver (EASL) criteria, and modified RECIST (mRECIST) for assessing the response of patients with hepatocellular carcinoma to treatment with sorafenib combined with transarterial chemoembolization. Here, we aimed to define the earliest time at which the response to combination therapy could be accurately assessed and validate the prognostic value of these criteria at this early posttherapy time point. Experimental Design: A total of 114 consecutive patients with hepatocellular carcinoma receiving combination therapy were retrospectively enrolled. The therapy response at different time points was assessed using RECIST, EASL, and mRECIST. Cox regression analysis and Kaplan-Meier curves were used to assess overall survival (OS) in the responders and nonresponders. Results: At the third follow-up (median, 94 days; range, 89-102 days) after therapy, the response rates obtained using EASL (50.6%) and mRECIST (51.6%) were greater than that obtained using RECIST (16.5%). The agreement was strong between the mRECIST and EASL results (k = 0.9) but weak between mRECIST and RECIST (k = 0.3). The EASL and mRECIST responses significantly correlated with survival. Risk reductions of 52% and 50% were observed for EASL and mRECIST responders, respectively, compared with nonresponders. However, no significant association between the treatment response and survival was observed using RECIST. Conclusions: The earliest time to evaluate the response to combination therapy is 3 months (median, 94 days) after therapy. EASL and mRECIST responses are independent predictors for OS at this early time point. (C)2014 AACR.
引用
收藏
页码:1623 / 1631
页数:9
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