Efficacy of Prophylactic Entecavir for Hepatitis B Virus-Related Hepatocellular Carcinoma Receiving Transcatheter Arterial Chemoembolization

Autor: Zhan-Hong Chen, Dong-Hao Wu, Ze-Xiao Lin, Tian-Tian Wang, Jing-Yun Wen, Xing Li, Xiang-Yuan Wu, Xiao-Kun Ma, Li Wei, Xiang Zhong, Dan-Yun Ruan, Qu Lin, Min Dong, Jie Chen, Yan-Fang Xing
Rok vydání: 2016
Předmět:
Male
Cancer Research
Epidemiology
medicine.disease_cause
Gastroenterology
Hepatic Artery
0302 clinical medicine
Child
Aged
80 and over
Liver Neoplasms
Lamivudine
Entecavir
Middle Aged
Hepatitis B
Prognosis
Oncology
030220 oncology & carcinogenesis
Hepatocellular carcinoma
Female
030211 gastroenterology & hepatology
medicine.drug
Adult
Hepatitis B virus
medicine.medical_specialty
Carcinoma
Hepatocellular
Guanine
Adolescent
Antiviral Agents
Young Adult
03 medical and health sciences
Internal medicine
medicine
Humans
Chemoembolization
Therapeutic
Transcatheter arterial chemoembolization
Aged
Neoplasm Staging
Retrospective Studies
Hepatitis
Performance status
business.industry
Public Health
Environmental and Occupational Health
medicine.disease
digestive system diseases
Surgery
Case-Control Studies
Virus Activation
Liver function
business
Follow-Up Studies
Zdroj: Asian Pacific Journal of Cancer Prevention. 16:8665-8670
ISSN: 1513-7368
DOI: 10.7314/apjcp.2015.16.18.8665
Popis: Background and aims Hepatitis B virus (HBV) reactivation was reported to be induced by transcatheter arterial chemoembolization (TACE) in HBV-related hepatocellular carcinonma (HCC) patients with a high incidence. The effective strategy to reduce hepatitis flares due to HBV reactivation in this specific group of patients was limited to lamivudine. This retrospective study was aimed to investigate the efficacy of prophylactic entecavir in HCC patients receiving TACE. Methods A consecutive series of 191 HBV-related HCC patients receiving TACE were analyzed including 44 patients received prophylactic entecavir. Virologic events, defined as an increase in serum HBV DNA level to more than 1 log10 copies/ml higher than nadir the level, and hepatitis flares due to HBV reactivation were the main endpoints. Results Patients with or without prophylactic were similar in host factors and the majorities of characteristics regarding to tumor factors, HBV status, liver function and LMR. Notably, cycles of TACE were parallel between the groups. Ten (22.7%) patients receiving prophylactic entecavir reached virologic response. The patients receiving prophylactic entecavir presented significantly reduced virologic events (6.8% vs 54.4%, p=0.000) and hepatitis flares due to HBV reactivation (0.0% vs 11.6%, p=0.039) compared with patients without prophylaxis. Kaplan-Meier analysis illustrated that the patients in the entecavir group presented significantly improved virologic events free survival (p=0.000) and hepatitis flare free survival (p=0.017). Female and Eastern Cooperative Oncology Group (ECOG) performance status 2 was the only significant predictors for virological events in patients without prophylactic antiviral. Rescue antiviral therapy did not reduce the incidence of hepatitis flares due to HBV reactivation. Conclusion Prophylactic entecavir presented promising efficacy in HBV-related cancer patients receiving TACE. Lower performance status and female gender might be the predictors for HBV reactivation in these patients.
Databáze: OpenAIRE
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