- Comparative Study between Metronomic Chemotherapy and Transarterial Chemoembolization in Patients with Child-Pugh Class B Advanced Hepatocellular Carcinoma
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Hyun Yang, Myeong Jun Song, Hee Chul Nam, Hae Lim Lee, Sung Won Lee, Do Seon Song, Jeong Won Jang, Si Hyun Bae, Jong Yong Choi, Seung Kew Yoon
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J Liver Cancer. 2015;15(2):92-99. Published online September 30, 2015
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DOI: https://doi.org/10.17998/jlc.15.2.92
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Abstract
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- Background/Aim
s: Metronomic (MET) chemotherapy is a treatment characterized by
frequent infusion of low doses of chemotherapeutic agent without extended break. The aim
of this study is to evaluate the efficacy of MET chemotherapy compared with transarterial
chemoembolization (TACE) in patients with child B class advanced hepatocellular carcinoma
(HCC). Methods Seventy-three patients with child B class advanced HCC were analyzed between
April, 2007 and August, 2013 according to two treatment groups: (i) MET chemotherapy group
(n=43, Epirubicin 35 mg/body surface area [BSA] every 4 weeks, and cisplatin 15 mg/BSA and
5-fluorouracil 50 mg/BSA weekly for 3 weeks) via an implantable port system with 1 week
break. (ii) TACE group (n=30, Adriamycin 20-50 mg) every 4 weeks. Primary endpoint was
overall survival (OS). Results The median survival times in the MET and TACE groups were 4.5 months and
3.1 months, respectively. The overall survival rate showed significantly better in the MET
treatment group than in the TACE group (P=0.039). When the factors affecting patient
OS were analyzed, MET chemotherapy (P=0.038, hazard ratio {HR} 0.538 [95% confidence
interval {CI} 0.299-0.967]) was independently associated with OS. Larger maximal tumor size,
extrahepatic metastasis and advanced stage also were significant factors for OS (P=0.009, HR
1.064 [95% CI 1.014-16.064]; P=0.014, HR 2.120 [95% CI 1.164-3.861]; P=0.019, HR 2.046 [95% CI
1.125-3.720], respectively). Conclusions MET chemotherapy showed survival benefit than TACE in patients with child
class B advanced HCC. Therefore, MET chemotherapy may be considered as a treatment
option for advanced HCC with poor liver function. (J Liver Cancer 2015;15:92-99)
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Citations
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- A comparative study of sorafenib and metronomic chemotherapy for Barcelona Clinic Liver Cancer-stage C hepatocellular carcinoma with poor liver function
Hyun Yang, Hyun Young Woo, Soon Kyu Lee, Ji Won Han, Bohyun Jang, Hee Chul Nam, Hae Lim Lee, Sung Won Lee, Do Seon Song, Myeong Jun Song, Jung Suk Oh, Ho Jong Chun, Jeong Won Jang, Angelo Lozada, Si Hyun Bae, Jong Young Choi, Seung Kew Yoon Clinical and Molecular Hepatology.2017; 23(2): 128. CrossRef
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