A New Therapeutic Assessment Score for Advanced Hepatocellular Carcinoma Patients Receiving Hepatic Arterial Infusion Chemotherapy

作者：Saeki Issei; Yamasaki Takahiro^*; Tanabe Norikazu; Iwamoto Takuya; Matsumoto Toshihiko; Urata Yohei; Hidaka Isao; Ishikawa Tsuyoshi; Takami Taro; Yamamoto Naoki; Uchida Koichi; Terai Shuji; Sakaida Isao

来源：PLos One, 2015, 10(5): e0126649.

DOI：10.1371/journal.pone.0126649

Background & Aims
Hepatic arterial infusion chemotherapy (HAIC) is an option for treating advanced hepatocellular carcinoma (HCC). Because of the poor prognosis in HAIC non-responders, it is important to identify patients who may benefit from continuous HAIC treatment; however, there are currently no therapeutic assessment scores for this identification. Therefore, we aimed to establish a new therapeutic assessment score for such patients.
Methods
We retrospectively analyzed 90 advanced HCC patients with elevated baseline alpha-fetoprotein (AFP) and/or des-gamma-carboxy prothrombin (DCP) levels and analyzed various parameters for their possible use as predictors of response and survival. AFP and DCP responses were assessed after half a course of HAIC (2 weeks); a positive-response was defined as a reduction of >= 20% from baseline.
Results
Multivariate analysis identified DCP response (odds ratio 16.03, p < 0.001) as an independent predictor of treatment response. In multivariate analysis, Child-Pugh class A (hazard ratio [HR] 1.99, p = 0.018), AFP response (HR 2.17, p = 0.007), and DCP response (HR 1.90, p = 0.030) were independent prognostic predictors. We developed an Assessment for Continuous Treatment with HAIC (ACTH) score, including the above 3 factors, which ranged from 0 to 3. Patients stratified into two groups according to this score showed significantly different prognoses (<= 1 vs. >= 2 points: median survival time, 15.1 vs. 8.7 months; p = 0.003).
Conclusions
The ACTH score may be useful in the therapeutic assessment of HCC patients receiving HAIC.

• 出版日期2015-5-20