Efficacy Of Sorafenib For Advanced Hepatocellular Carcinoma And Prognostic Factors

Objective:To evaluate efficacy of Sorafenib (Nexavar) in the treatment ofadvanced hepatocellular carcinoma (HCC),and analyze the relevant affecting factors ofefficacy and prognosis.Materials and Methods:This essay retrospective analyze the medical record dataof65advanced HCC patients who received sorafenib treatment in Liaoning ProvincialTumor Hospital from June2008to June2012,evaluate the efficacy and adversereactions.Using response rate(RR) and disease control rate(DCR)as efficacy indicatorsto do univariate and logistic regression analysis.Using overall survival(OS) andprogression free survival(PFS)as prognostic indicators to do Kaplan-Meier method andCox proportional hazards model multivariate analysis.Results:The median observation time is8(4to19) months,11(16.9%) of65patients have had CR,11patients (16.9%) have had PR,28patients (43%) havehad SD,the overall disease response rate and overall disease control rate are33.8%and76.9%.The median OS is10.0months, the median PFS is4.5months.Univariate analysis showed that:age,EOCG PS score,extrahepatic metastasis,co-treatment,Child-Pugh classification associate with RR,patient who≤55years old,have lower EOCG PS score,no extrahepatic metastasis,take sorafenib plus TACE treatment,and Child-Pugh A have a higher RR;EOCG PS score,extrahepatic metastasis,co-treatment,Child-Pugh classification associate with DCR,patient who have lower EOCG PS score,no extrahepatic metastasis,take sorafenib plus TACE treatment,and Child-Pugh A have a higher DCR;EOCG PS score,co-treatment,Child-Pugh classification and AFP level affect OS,patient who have lower EOCG PS score,take sorafenib plus TACE treatment,Child-Pugh A,and lower AFP level have a longer OS;EOCG PS score,co-treatment,Child-Pugh classification and AFP level affect PFS,patient who have lower EOCG PS score,take sorafenib plus TACE treatment,Child -Pugh A,and lower AFP level have a longer PFS.Multivariate analysis shows that:the Eastern Cooperative Oncology Group active ratings (ECOG PS) is the independent impactive factor of DCR,the situation of extrahepatic metastasis and combined with TACE are independent impactive factors of RR.EOCG PS,combined with TACE,Child-Pugh classification and AFP level are independent prognostic factors of PFS,EOCG PS,Child-Pugh classification and AFP level are independent prognostic factors of OS.Conclusion:Sorafenib treatment of advanced hepatocellular carcinoma is safe andeffective.Patient who have lower EOCG PS score,no extrahepatic metastasis,takesorafenib plus TACE treatment,and Child-Pugh A have better efficacy;patient whohave lower EOCG PS score,take sorafenib plus TACE treatment,Child-Pugh A,andlower AFP level have a better prognosis.EOCG PS score,Child-Pugh classification andthe AFP level are independent predictors of prognosis.Combined with TACE therapycan help to improve the efficacy and long-term survival.Combined therapy have asimilar security with sorafenib,no more liver injury and bleeding events.Gender,tumordiameter,number of tumor,portal violations and HBV infection have no effect forefficacy and survival.