背景: 1. 定义:不可切除肝癌
Advanced BCLC stage C hepatocellular carcinoma (HCC)
– Symptomatic tumors or
– Invasive tumoral pattern (vascular invasion /extrahepatic spread)【1】
2. 治疗选择有限,预后差 3. 索拉非尼和安慰剂治疗比较:中位生存获益2.3个月和2.8个月【2,3】 4. 已知DEB-TACE 总体中位生存期(overall median survival)13.5月【4】 5. Child-pugh A病人没有PVT/met:18.8月【4】 如何评价不可切除肝癌的生存趋势并与第三方相似肝癌病人DEB-TACE治疗比较? 应用美国国家癌症研究院(NCI)SEER数据库中晚期不可切除肝癌病人病例,与DEB-TACE病人比较 方法: 1. 入组标准:SEER数据库不可切除肝癌病人和DEB-TACE队列研究病人
2. 来自SEER数据库的病人
3. 来自DEB-TACE病人的选择
5. 统计学分析 1. Llovet JM, Brú C, Bruix J. Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis. 1999;19(3):329-38. 2. Cheng AL, Kang YK, Chen Z, Tsao CJ, Qin S, Kim JS, Luo R, Feng J, Ye S, Yang TS, Xu J, Sun Y, Liang H, Liu J, Wang J, Tak WY, Pan H, Burock K, Zou J, Voliotis D, Guan Z. Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: a phase III randomised, double-blind, placebo-controlled trial. Lancet Oncol. 2009 Jan;10(1):25-34. 3. Llovet JM, Ricci S, Mazzaferro V, Hilgard P, Gane E, Blanc JF, de Oliveira AC, Santoro A, Raoul JL, Forner A, Schwartz M, Porta C, Zeuzem S, Bolondi L, Greten TF, Galle PR, Seitz JF, Borbath I, Häussinger D, Giannaris T, Shan M, Moscovici M, Voliotis D, Bruix J; SHARP Investigators Study Group. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008 Jul 24;359(4):378-90. 4. Prajapati HJ, Dhanasekaran R, El-Rayes BF, Kauh JS, Maithel SK, Chen Z, Kim HS. Safety and efficacy of doxorubicin drug-eluting bead transarterial chemoembolization in patients with advanced hepatocellular carcinoma. J Vasc Interv Radiol. 2013 Mar;24(3):307-15. |