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Original Article Sorafenib Combined with Transarterial-Chemoembolization in Child-Pugh Class B Patients with Hepatocellular Carcinoma
Jong Sik Lee, Sun Young Moon, Kyung Ann Lee, Jae Ki Min, Sung Jin Jeon, In Ae Kim, Kang Hoon Lee, Won Hyeok Choe, Jeong Han Kim, So Young Kwon
Journal of Liver Cancer 2014;14(1):31-36
Published online: March 31, 2014
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Department of Internal Medicine, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea

/Aims: The aim of the study is to investigate efficacy and safety of sorafenib combined with transarterial chemoembolization (TACE) in Child-Pugh (CP) class-B patients with hepatocellular carcinoma (HCC).
A total of 12 CP class-B patients who were initially treated with sorafenib combined with TACE were retrospectively reviewed. At 14 days after the first TACE, patients were continuously treated with sorafenib until unacceptable adverse events (AEs) or diseaseprogression. Consecutive TACEs were also performed, if patients were tolerable.
Of 12 patients, 8, 3 and 1 patients had CP-score 7, 8, and 9, respectively. The median overall survival was 85 days. Patients underwent median 2 sessions of TACE (range 1-4) and the median duration of sorafenib was 48days (range, 12-92 days). Three patients refused repeated TACEs and 4 patients required delay of the consecutive TACE due to AEs of sorafenib. Six patients required transient or permanent discontinuation of sorafenib, due to its AEs (grade 1/2 AEs, 2 patients; grade 3/4 AEs, 4 patients). High CP score (score 8/9 vs. 7) was tended to be association with interruption of sorafenib (P=0.061) and requirement of refusal/ delay of consecutive TACE (P=0.081).
Sorafenib combined with TACE were frequently interrupted or delayed in CP class-B patients, mostly because of its side effects, even though there were not serious. Our experiences suggest that combination with sorafenib and TACE might interface with each other due to its side effects in CP class-B patients, especially patients with CP score 8/9 liver cirrhosis.

JLC : Journal of Liver Cancer