Bi-monthly hepatic arterial infusion chemotherapy as a novel strategy for advanced hepatocellular carcinoma in decompensated cirrhotic patients
- Author:
Kei MORIYA
1
;
Tadashi NAMISAKI
;
Shinya SATO
;
Masanori FURUKAWA
;
Akitoshi DOUHARA
;
Hideto KAWARATANI
;
Kosuke KAJI
;
Naotaka SHIMOZATO
;
Yasuhiko SAWADA
;
Soichiro SAIKAWA
;
Hiroaki TAKAYA
;
Koh KITAGAWA
;
Takemi AKAHANE
;
Akira MITORO
;
Junichi YAMAO
;
Hitoshi YOSHIJI
Author Information
- Publication Type:Original Article
- Keywords: Carcinoma, Hepatocellular; Liver cirrhosis; Cisplatin; Drug therapy; Decompensated cirrhosis
- MeSH: Carcinoma, Hepatocellular; Cisplatin; Drug Therapy; Fibrosis; Humans; Liver Cirrhosis; Survival Rate
- From:Clinical and Molecular Hepatology 2019;25(4):381-389
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND AND AIMS: We previously reported the comparable efficacy of bi-monthly hepatic arterial infusion chemotherapy (B-HAIC) to that of sorafenib chemotherapy for the treatment of advanced hepatocellular carcinoma (aHCC) in patients with compensated cirrhosis. In this study, we demonstrate the efficacy of B-HAIC in patients with decompensated cirrhosis.METHODS: Forty-five patients with aHCC refractory to transcatheter arterial chemo-embolization (TACE) were treated with B-HAIC and were divided into two groups according to hepatic functional reserve (Child-Pugh grade). Overall survival period, treatment response, and adverse events in each group were analyzed.RESULTS: Efficacy and disease control rates in the Child-Pugh B group (n=24; 21% and 71%, respectively) were not significantly impaired compared the Child-Pugh A group (n=21; 38% and 67%, respectively). Median survival time and survival rate at 12 months in the Child-Pugh B group were 422 days and 58.3%, respectively, whereas those in the Child-Pugh A group were 567 days and 70.8%, respectively. Importantly, the hepatic functional reserve of patients did not worsen in either group during the treatment period. Furthermore, the occurrence rate of adverse events leading to discontinuation of anti-tumor treatment was not significantly increased in the Child-Pugh B group.CONCLUSIONS: Given the preservation of hepatic functional reserve afforded by B-HAIC chemotherapy in patients with decompensated cirrhosis, B-HAIC might be an acceptable alternative strategy for aHCC patients who do not respond to TACE.
