OBJECTIVES

To investigate the 3-year prescription pattern of adjuvant drugs and analgesics (ADA) in hepatic carcinoma (HCC) in China and identify the gap between clinical practice guidelines and clinical practice.

METHODS

Electronic medical records of 3,830 patients hospitalized during 2016-2018 with HCC were extracted from National Cancer Big Data Platform of China using ICD-10 code. Prescription patterns of ADA were categorized into immunoregulation agent, hepatic protector, antiemetics, and analgesics. Age, admission date, frequency and ratio of ADA usage per patient in each year were recorded and described by stage and chemoradiotherapy usage.

RESULTS

A decreasing trend showed among the ADA users in each stage patients in 2016-2018. Patients under chemoradiotherapy have higher percentage in medical orders for receiving immunoregulation agent (19.25% VS 5.54%), hepatic protector (70.06% VS 42.85%), and antiemetics (50.97% VS 4.23%). Stage IV HCC is of the highest analgesics usage. The immunoregulation agent usage ratio in HCC stage I has over twice of other stages (18.07% VS 8.30%). The average hepatic protector usage across four stages is 53.15%，and the highest usage ratio is in stage III patients which is 73.1%. The most commonly used immunoregulation agent and hepatic protector were recombinant human granulocyte colony stimulating factor injection and reduced glutathione injection.

CONCLUSIONS

The study shows that ADA clinical practice among HCC accord with Chinese Society of Clinical Oncology guideline, however, there are still insufficiencies in ADA medical evidence supporting in this guideline. Moreover, HCC analgesics usage ratio is far below the actual patient population, which is reported 70%-80% HCC patients suffering from pain. This may result from lack of cancer pain management guidelines in China. In conclusion, the real world studies help the understanding on the actual ADA usage in China and boost the publishing of related medical policies and contribute to the development of clinical practice.