Efficacy and safety of hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma as first-line therapy.
10.3350/cmh.2013.19.3.288
- Author:
Myung Jin OH
1
;
Heon Ju LEE
;
Si Hyung LEE
Author Information
1. Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea. hjlee@med.yu.ac.kr
- Publication Type:Original Article
- Keywords:
Carcinoma, Hepatocellular;
Hepatic arterial infusion chemotherapy;
Child-Pugh class;
Overall survival;
Progression-free survival
- MeSH:
Adult;
Aged;
Anemia/etiology;
Antineoplastic Agents/adverse effects/*therapeutic use;
Carcinoma, Hepatocellular/*drug therapy;
Cisplatin/adverse effects/*therapeutic use;
Diarrhea/etiology;
Disease-Free Survival;
Drug Therapy, Combination;
Female;
Fluorouracil/adverse effects/*therapeutic use;
Humans;
Infusions, Intra-Arterial;
Kaplan-Meier Estimate;
Liver Neoplasms/*drug therapy;
Male;
Middle Aged;
Neutropenia/etiology;
Retrospective Studies;
Severity of Illness Index;
Thrombocytopenia/etiology;
Treatment Outcome
- From:Clinical and Molecular Hepatology
2013;19(3):288-299
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Hepatic arterial infusion chemotherapy (HAIC) with 5-fluorouracil and cisplatin for intractable advanced hepatocellular carcinoma (HCC) may have survival benefits. We aimed to determine the efficacy and safety of HAIC for advanced HCC as first-line therapy. METHODS: A total of 54 patients who received only HAIC with 5-fluorouracil (750 mg/m2 on days 1-4) and cisplatin (25 mg/m2 on days 1-4) for advanced HCC from Jan. 2009 to Dec. 2011 were selected. According to Child-Pugh class, the overall survival (OS), progression-free survival (PFS), and adverse events after HAIC were investigated retrospectively. RESULTS: Median OS and PFS between the Child-Pugh A group (n=24) and the Child-Pugh B/C group (n=30) were 8.7 (95% confidence interval [CI]: 4.7-12.7) vs. 3.7 months (95% CI: 2.0-5.3), and 7.1 (95% CI: 3.8-10.4) vs. 3.6 months (95% CI: 2.0-5.2), respectively. Although median OS and PFS were not statistically significant between the two groups (P=0.079, P=0.196), the Child-Pugh class B/C tended to influence poor OS. Serious adverse events > or = grade 3 occurred frequently in both groups (83.3 vs. 96.7%, P=0.159). Responders (22.2%, complete or partial response) significantly differed in median OS, compared to non-responders (13.1 vs. 4.4 months, P=0.019). Achievement of complete or partial response was an independent prognostic factor of OS (hazard ratio: 0.4, 95% CI: 0.2-0.8, P=0.011). CONCLUSIONS: Achievement of response after HAIC provide a survival benefit in patients with advanced HCC, but HAIC should be administered cautiously in patients with Child-Pugh class B/C, because of a relatively low survival and high incidence of serious adverse events.
