1.Bi-monthly hepatic arterial infusion chemotherapy as a novel strategy for advanced hepatocellular carcinoma in decompensated cirrhotic patients
Kei MORIYA ; 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
Clinical and Molecular Hepatology 2019;25(4):381-389
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.
Carcinoma, Hepatocellular
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Cisplatin
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Drug Therapy
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Fibrosis
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Humans
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Liver Cirrhosis
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Survival Rate
Result Analysis
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