Transarterial chemoembolization combined with sorafenib for hepatocellular carcinoma in BCLC-C stage: clinical analysis of 20 cases

Objective: To evaluate the efficacy of transarterial chemoembolization (TACE) combined with sorafenib in treating hepatocellular carcinoma (HCC) in Barcelona Clinic Liver Cancer-C stage (BCLC-C stage), and to provide the useful basis for selecting reasonable therapeutic scheme in clinic practice. Methods: A total of 76 patients with BCLC-C stage HCC, who were encountered during the period from August 2008 to January 2014 at authors' hospital, were enrolled in this study. All patients had complete clinical materials. The clinical data were retrospectively analyzed. According to the therapy adopted, the patients were divided into group A (TACE group, n = 29), group B (TACE combined with sorafenib, n = 20) and group C (supportive treatment, n = 27). The observation indices included median overall survival time (MOS), median time to progression (MTTP), disease control rate (DCR) and 3-, and 15-month survival rate. The results were statistically analyzed. Results: MOS of the group A$ B and C were 9.2 months, 12.6 months and 3.1 months respectively (P < 0.01). MTTP of the group A, B and C were 3.2 months, 5.6 months and 1.5 months respectively (P < 0.01). DCR within 1-2 months of the group A, B and C were 82.8%, 85% and 14.8% respectively (P < 0.01). For group A, B and C the 3-, 9- and 15-month survival rates were 100%, 100% and 51.9% (P < 0.01), 51.7%, 85% and 0% (P < 0.01) and 10.3%, 40% and 0% (P < 0.01), respectively. No statistically significant differences in DCR and 3-month survival rate existed between group A and group B (P > 0.05). Conclusion: For the treatment of BCLC-C stage HCC, TACE combined with sorafenib carries the best therapeutic effect. For the patients who can not endure the combination therapy, simple TACE is superior to supportive treatment. (authors)