title: Concurrent sorafenib therapy extends the interval to subsequent TACE for patients with unresectable hepatocellular carcinoma.
abstract: OBJECTIVE
  To compare the impact of concurrent TACE + sorafenib versus TACE alone on overall survival (OS) and time to progression (TTP) in patients with unresectable hepatocellular carcinoma (uHCC). A secondary goal was to determine if sorafenib use increases the interval between courses of TACE.
  
  
  METHODS
  This study enrolled 150 patients with uHCC from June 2011 to June 2014, including 50 treated with TACE + sorafenib and 100 treated with TACE alone. Factors associated with OS and TTP were identified by univariate and multivariate Cox-regression model analyses. Average TACE interval was defined as TTP/TACE frequency.
  
  
  RESULTS
  The median OS (21.7 vs. 11.5 months) and TTP (10.2 vs. 6.7 months) were longer in the TACE + sorafenib group compared to the TACE group. Patients receiving combination therapy had higher survival rate (P < 0.032) and longer average interval to TACE (P < 0.001), but lower progression rate (P < 0.001). TACE + sorafenib therapy was associated with improved OS (P ≤ 0.009) and TTP (P ≤ 0.021). The majority of AEs identified in patients receiving the combination therapy were classified as Grades 1 and 2, and skin-related reactions and fatigue were the most common.
  
  
  CONCLUSIONS
  Concurrent sorafenib with TACE provides survival benefits over TACE monotherapy, which may be related to a prolonged interval between subsequent TACE courses. J. Surg. Oncol. 2016;113:672-677. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Interventional Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Xuesong
authors.initials: X
authors.lastname: Yao
authors.affiliation: Department of Interventional Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Yan
authors.affiliation: Department of Interventional Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Huiying
authors.initials: H
authors.lastname: Zeng
authors.affiliation: Department of Interventional Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Dengzhong
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Interventional Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Huai
authors.initials: H
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use*; D011446:Prospective Studies; D000077157:Sorafenib; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib
keywords: hepatocellular carcinoma; progression; sorafenib; survival; transarterial chemoembolization