Supplementary Material for: Addition of Local Hepatic Therapy to Sorafenib in Patients with Advanced Hepatocellular Carcinoma (Stage BCLC C)

<b><i>Background/Aims:</i></b> For most patients with hepatocellular carcinoma (HCC), diagnosis is invariably done only in the advanced stages of the disease. For advanced, non-metastatic stage, standard therapy is transarterial chemoembolization (TACE). For metastatic disease, the recommended therapy is systemic treatment with sorafenib. In this study, we evaluated the benefit of an additional local hepatic treatment for patients with advanced metastatic disease. <b><i>Methods:</i></b> In a retrospective study, we assessed the overall survival (OS), time to progression (TTP), and disease control rate (DCR) in 37 patients with metastasized HCC treated with sorafenib. Sixteen patients received additional local therapy, while 21 patients received only sorafenib. <b><i>Results:</i></b> Median OS of patients with combined therapy was significantly higher with 25 months (95% CI: 13.7-36.3 months) as compared to 11 months (95% CI: 6.2-15.8 months) in patients treated with sorafenib alone. TTP was 7 months (95% CI: 5.3-8.7 months) compared to 5 months (95% CI: 3-7 months) and DCR was 87 versus 72% after 3 months and 31 versus 22% after 9 months. <b><i>Conclusion:</i></b> These data suggest that control of the liver tumor burden by local therapy in combination with sorafenib might prove beneficial for metastasized HCC. Randomised studies are needed to confirm this exploratory finding. © 2014 S. Karger AG, Basel

<b><i>背景与目的：</i></b> 对于大多数肝细胞癌（hepatocellular carcinoma, HCC）患者而言，确诊时往往已处于疾病晚期。针对晚期非转移性肝细胞癌，标准治疗方案为经动脉化疗栓塞术（transarterial chemoembolization, TACE）；而转移性肝细胞癌的推荐治疗方案为索拉非尼系统治疗。本研究旨在评估晚期转移性肝细胞癌患者联合局部肝脏治疗的临床获益。<b><i>方法：</i></b> 本研究为回顾性研究，共纳入37例接受索拉非尼治疗的转移性肝细胞癌患者，评估其总生存期（overall survival, OS）、进展时间（time to progression, TTP）以及疾病控制率（disease control rate, DCR）。其中16例患者接受了联合局部治疗，剩余21例患者仅接受索拉非尼单药治疗。<b><i>结果：</i></b> 联合治疗组患者的中位总生存期为25个月（95%置信区间：13.7~36.3个月），显著高于索拉非尼单药治疗组的11个月（95%置信区间：6.2~15.8个月）。联合治疗组的中位进展时间为7个月（95%置信区间：5.3~8.7个月），单药治疗组为5个月（95%置信区间：3~7个月）；治疗3个月时的疾病控制率分别为87%与72%，治疗9个月时则分别为31%与22%。<b><i>结论：</i></b> 本研究数据表明，局部治疗联合索拉非尼以控制肝脏肿瘤负荷，或许可为转移性肝细胞癌患者带来获益。未来仍需开展随机对照研究以验证这一探索性发现。© 2014 S. Karger AG, 巴塞尔