在直接作用抗病毒药物后,C型肝炎病毒相关的一年肝细胞癌复发:随机对照试验
Ahmed Kamal1, Marwa Metawea2, Heba Omar3,4
1Hepatology Unit, Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt. Ahmed.kamal@alexmed.edu.eg.
Journal of gastrointestinal cancer
|March 4, 2024
概括
直接作用抗病毒药物 (DAA) 显著减少肝细胞癌 (HCC) 在C型肝炎病毒 (HCV) 患者的切除后复发. 与延迟治疗相比,早期的DAA治疗改善了无复发的生存率.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 在瘤学瘤学.
- 传染性疾病 传染性疾病
背景情况:
- 在治疗型肝炎病毒 (HCV) 后,肝细胞癌 (HCC) 复发是一个重大的临床挑战.
- 关于直接作用抗病毒药物 (DAA) 对HCV治疗后HCC复发的影响的数据是相互矛盾的,随机试验缺乏.
研究的目的:
- 为了比较DAA治疗患者的1年HCC复发率与那些在瘤切除后推迟HCV治疗的患者.
- 为了评估早期DAA启动在预防HCC复发后的疗效.
主要方法:
- 随机试验比较即时的DAA (索福斯布维尔/韦尔帕塔斯维尔) 与12个月的DAA延期组在完全切除HCC后.
- 使用卡普兰-梅尔和多变量分析对HCC复发率进行1年的随访.
主要成果:
- 随机分配了84名患有HCC的患者;43人接受了即时的DAA,41人推迟了治疗.
- 与延期组相比,即时DAA组的1年无复发存活率显著更高 (72.2%) (38%,P=0.001).
- 立即的DAA治疗和更高的白蛋白水平独立地与明显较低的HCC复发风险相关.
结论:
- 在完全切除HCC后开始的直接作用抗病毒疗法显著降低了1年复发率.
- 虽然DAA降低了复发风险,但HCC复发的可能性并没有完全消除.
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