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World J Gastroenterol. 2012 Jul 14;18(26):3426-34. doi: 10.3748/wjg.v18.i26.3426.

Efficacy of hepatic arterial infusion chemotherapy in advanced hepatocellular carcinoma.

Author information

1
Department of Internal Medicine, Dong-A University College of Medicine, Busan 602-103, South Korea.

Abstract

AIM:

To investigate the efficacy of hepatic arterial infusion chemotherapy (HAIC) using floxuridine (FUDR) in patients with advanced hepatocellular carcinoma (HCC) confined to the liver.

METHODS:

Thirty-four patients who had advanced HCC with unresectability or unsuccessful previous therapy in the absence of extrahepatic metastasis were treated with intra-arterial FUDR chemotherapy at our hospital between March 2005 and May 2008. Among the 34 patients, 9 patients were classified as Child class C, and 18 patients had portal vein tumor thrombus (PVTT). One course of chemotherapy consisted of continuous infusion of FUDR (0.3 mg/kg during day 1-14) and dexamethasone (10 mg on day 1, 4, 7 and 11), and this treatment was repeated every 28 d.

RESULTS:

Two patients (5.9%) displayed a complete response, and 12 patients (35.3%) had a partial response. The tumor control rate was 61.8%. The median overall survival times were 15.3 mo, 12.4 mo and 4.3 mo for the patients who were classified as Child class A, Child class B and Child class C, respectively (P = 0.0392). The progression-free survival was 12.9 mo, 7.7 mo and 2.6 mo for the patients who were classified as Child class A, Child class B and Child class C, respectively (P = 0.0443). The cumulative survival differed significantly according to the Child-Pugh classification and the presence of PVTT. In addition to hepatic reserve capacity and PVTT, the extent of HCC was an independent factor in determining a poor prognosis. The most common adverse reactions to HAIC were mucositis, diarrhea and peptic ulcer disease, but most of these complications were improved by medical treatment and/or a delay of HAIC.

CONCLUSION:

The present study demonstrates that intra-arterial FUDR chemotherapy is a safe and effective treatment for advanced HCC that is recalcitrant to other therapeutic modalities, even in patients with advanced cirrhosis.

KEYWORDS:

Advanced hepatocellular carcinoma; Child-Pugh classification; Floxuridine; Hepatic arterial infusion chemotherapy; Portal vein tumor thrombus

PMID:
22807613
PMCID:
PMC3396196
DOI:
10.3748/wjg.v18.i26.3426
[Indexed for MEDLINE]
Free PMC Article

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