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- Title
Early on-treatment predictions of clinical outcomes using alpha-fetoprotein and des-gamma-carboxy prothrombin responses in patients with advanced hepatocellular carcinoma.
- Authors
Lee, Myoung Ha; Kim, Seung Up; Kim, Do Young; Ahn, Sang Hoon; Choi, Eun Hee; Lee, Kwang Hun; Lee, Do Yun; Seong, Jinsil; Han, Kwang-Hyub; Chon, Chae Yoon; Park, Jun Yong
- Abstract
Background and Aim: The clinical utility of alpha-fetoprotein (AFP) and des-γ-carboxy prothrombin (DCP) as a predictor of treatment outcome in patients with advanced hepatocellular carcinoma (HCC) receiving hepatic artery infusional chemotherapy (HAIC) or concurrent chemoradiation therapy (CCRT) has been poorly defined. Methods: Between January 2003 and December 2007, we enrolled 127 treatment-naïve patients who received HAIC ( n = 60) or CCRT ( n = 67) as an initial treatment modality. An AFP or DCP response was defined as a reduction of more than 20% from the baseline level. Results: AFP responders showed significantly better overall survival (OS) than non-responders among patients with HAIC (median 17.3 vs 6.4 months, P < 0.001) and with CCRT (median 17.6 vs 8.7 months, P = 0.014). DCP responders in the CCRT group also showed significantly better progression-free survival (PFS) than non-responders (median 9.2 vs 3.1 months, P < 0.001). Multivariate Cox regression analyses showed that AFP response was independently predictive of OS in both groups ( P = 0.009 in HAIC and P = 0.008 in CCRT) whereas DCP only predicted PFS in patients with CCRT ( P = 0.015). Conclusions: Early on-treatment AFP response was predictive of OS in treatment-naïve patients with advanced HCC receiving HAIC and CCRT as an initial treatment modality. Furthermore, DCP response was useful for predicting PFS in patients with CCRT.
- Subjects
EARLY medical intervention; TREATMENT effectiveness; ALPHA fetoproteins; PROTHROMBIN; LIVER cancer patients
- Publication
Journal of Gastroenterology & Hepatology, 2012, Vol 27, Issue 2, p313
- ISSN
0815-9319
- Publication type
Article
- DOI
10.1111/j.1440-1746.2011.06867.x