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World J Gastroenterol. 2013 Aug 7;19(29):4679-88. doi: 10.3748/wjg.v19.i29.4679.

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

Author information

1
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 137-040, South Korea.

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.

KEYWORDS:

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

PMID:
23922465
PMCID:
PMC3732840
DOI:
10.3748/wjg.v19.i29.4679
[Indexed for MEDLINE]
Free PMC Article

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