Literature DB >> 23922465

Hepatic arterial infusion chemotherapy in hepatocellular carcinoma with portal vein tumor thrombosis.

Do Seon Song1, Si Hyun Bae, Myeong Jun Song, Sung Won Lee, Hee Yeon Kim, Young Joon Lee, Jung Suk Oh, Ho Jong Chun, Hae Giu Lee, Jong Young Choi, Seung Kew Yoon.   

Abstract

AIM: To evaluate the prognostic factors and efficacy of hepatic arterial infusion chemotherapy in hepatocellular carcinoma with portal vein tumor thrombosis.
METHODS: Fifty hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT) were treated using hepatic arterial infusion chemotherapy (HAIC) via a subcutaneously implanted port. The epirubicin-cisplatin-5-fluorouracil (ECF) chemotherapeutic regimen consisted of 35 mg/m(2) epirubicin on day 1, 60 mg/m(2) cisplatin for 2 h on day 2, and 500 mg/m(2) 5-fluorouracil for 5 h on days 1-3. The treatments were repeated every 3 or 4 wk.
RESULTS: Three (6%) of the 50 patients achieved a complete response (CR), 13 (26%) showed partial responses (PR), and 22 (44%) had stable disease (SD). The median survival and time to progression were 7 and 2 mo, respectively. After 2 cycles of HAIC, CR was achieved in 1 patient (2%), PR in 10 patients (20%) and SD in 26 patients (52%). Significant pre-treatment prognostic factors were a tumor volume of < 400 cm(3) (P = 0.01) and normal levels of protein induced by vitamin K absence or antagonist (PIVKA)-II (P = 0.022). After 2 cycles of treatment, disease control (CR + PR + SD) (P = 0.001), PVTT response (P = 0.003) and α-fetoprotein reduction of over 50% (P = 0.02) were independent factors for survival. Objective response (CR + PR), disease control, PVTT response, and combination therapy during the HAIC were also significant prognostic factors. Adverse events were tolerable and successfully managed.
CONCLUSION: HAIC may be an effective treatment modality for advanced HCC with PVTT in patients with tumors < 400 cm(3) and good prognostic factors.

Entities:  

Keywords:  Hepatic arterial infusion chemotherapy; Hepatocellular carcinoma; Portal vein tumor thrombosis

Mesh:

Substances:

Year:  2013        PMID: 23922465      PMCID: PMC3732840          DOI: 10.3748/wjg.v19.i29.4679

Source DB:  PubMed          Journal:  World J Gastroenterol        ISSN: 1007-9327            Impact factor:   5.742


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