Abstract:

Objective To evaluate the efficacy and safety of sorafenib in the treatment of advanced primary liver cancer and analyze factors that may affect drug outcomes. Methods Medical records of 78 patients with advanced primary liver cancer who received sorafenib from January 2008 to September 2013 were analyzed. Logistic regression was used to identify variables influencing response rate and disease control rate. Overall survival and progression-free survival were estimated using the Kaplan-Meier method， and Cox proportional hazard multivariate modeling was used to identify prognostic factors. Results Median follow-up time for the 78 patients was 192 days（95%CI 173-218）. No complete remission or partial remission was observed，and stable disease occurred in 48 patients（61.5%），corresponding to a disease control rate of 61.5%. Disease progression occurred in 30 patients. Median overall survival was 196 days （95%CI 173-218） and median progression-free survival was 96 days（95%CI 93-98）. Multivariate analysis identified age and HBV infection as independent risk factors for disease control rate. Child-Pugh class and previous chemotherapy were identified as independent prognostic factors of overall and progression-free survival. ECOG performance status was also found to be an independent predictor of overall survival. Most adverse events were grade 1 or 2. Two patients experienced grade IV hand-foot syndrome. No treatment-related deaths were recorded. Conclusion Sorafenib shows substantial survival benefit and tolerable toxicity in patients with advanced primary liver cancer. Lower ECOG performance status， Child-Pugh A class and previous chemotherapy predict better survival.

Key words: Liver neoplasm, Sorafenib, Chemotherapy, Efficacy, Prognostic factors