Efficacy of FOLFOX4 Regimen with Advanced Hepatocellular Carcinoma and Prognostic Factors for Survival
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Abstract
Background: To determine efficacy of FOLFOX4 regimen (oxaliplatin + 5-fluorouracil/leucovorin) in terms of overall survival (OS), progression-free survival (PFS), response rate (RR) and explore prognostic factors for survival in Thai patients with advanced hepatocellular carcinoma (HCC) who cannot access targeted therapy.
Methods: A retrospective cohort study was conducted in Surin hospital between July 2014 and April 2020. All medical records of 38 patients were reviewed for demographic data, risk factors, staging, treatment and outcomes. Kaplan-Meier model was used for survival time analysis. Prognosticfactors were performed by flexible parametric regression model both univariate and multivariate analysis.
Results: The mean age was 58.1(±10.0) years and predominant in male (81.6%). Hepatitis B infection and alcoholic consumption were common risk factors. Most of patients were BCLC stage C (94.8%). Median PFS and OS at prespecified time point were 2.9 months (95%CI, 2.2-4.1) and 4.2 months (95%CI, 2.6-5.0), respectively. The response rate (RR) and disease control rate (DCR) were 29.2% and 41.7%. Female gender, BCLC stage C and D, hepatitis B infection, hepatitis C infection and alpha-fetoprotein (AFP) >400 ng/ml were poor prognostic factors by univariate analysis. According to multivariate analysis, BCLC stage D (HR 231.83; 95%CI, 6.42-8370.24; p=0.003), hepatitis B infection (HR 4.39; 95%CI, 1.01-19.00; p=0.048) and hepatitis C infection (HR 30.93; 95%CI, 4.56-209.69; p<0.001) were independent prognostic factors for poor survival.
Conclusion: Along with these results of PFS, OS and RR, suggests that FOLFOX4 regimen may confer some benefit and can be an option for treatment advanced HCC in patients who cannot access targeted therapy.BCLC stage D, hepatitis B or C infection, female and AFP >400 ng/ml are poor prognostic factors for survival.
Keywords: hepatocellular carcinoma, chemotherapy, FOLFOX4, prognostic factors, survival
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References
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