古市　好宏
   Department   School of Medicine(Tokyo Women's Medical University Adachi Medical Center), School of Medicine
   Position   Associate Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Hepatocellular carcinoma treated with sorafenib: early detection of treatment response and major adverse events by contrast-enhanced US.
Journal Formal name：Liver international : official journal of the International Association for the Study of the Liver
Abbreviation：Liver Int
ISSN code：14783231/14783223
Domestic / ForeginForegin
Volume, Issue, Page 33(4),pp.605-15
Author and coauthor Sugimoto Katsutoshi, Moriyasu Fuminori, Saito Kazuhiro, Rognin Nicolas, Kamiyama Naohisa, Furuichi Yoshihiro, Imai Yasuharu
Publication date 2013/04
Summary BACKGROUND & AIMS:Early prediction of tumour response and major adverse events (AEs), especially liver failure, in patients with hepatocellular carcinoma (HCC) is essential for maximizing the clinical benefits of sorafenib. To evaluate the usefulness of dynamic contrast-enhanced ultrasound (DCE-US) for the early prediction of tumour response and major AEs in HCC patients.METHODS:Thirty-seven HCC patients were started on a reduced dosage of sorafenib, subsequently increased to the standard dosage. Tumour response at 1 month was assessed by CT using the Response Evaluation Criteria in Solid Tumors (RECIST). Major AEs were defined as grade 3 or higher. DCE-US was performed before treatment (day 0) and on days 7, 14 and 28. Changes in perfusion parameters in the tumour and liver parenchyma between day 0 and later time points were compared between treatment responders and nonresponders based on RECIST and between patients who experienced major AEs and those who did not. Tumour results were also compared with progression-free survival (PFS) and overall survival (OS).RESULTS:Tumour perfusion parameters based on the area under the time-intensity curve (AUC) were statistically significant, with AUC during washin on day 14, the most relevant for tumour response (P = 0.0016) and AUC during washin on day 7, the most relevant for both PFS (P = 0.009) and OS (P = 0.037). A decrease in total AUC between days 0 and 7 in the liver parenchyma was strongly correlated with major AEs (P = 0.0002).CONCLUSION:DCE-US may be useful for the early prediction of tumour response and major AEs in patients with HCC.
DOI 10.1111/liv.12098
PMID 23305331