Clinical study on the sensitivity test guided hepato-arterial/portal-vein chemotherapy in patients with unresectable hepatocellar carcinoma

Dongde Wu,Xinghong Wu,Shaozhong Wei,Feng Zhang,Lei Nie,Yaojun Feng,Chenggang Luo,Xiaoqin Xia

doi:10.14319/ijcto.0202.9

Abstract

Purpose: Approximately 20 % of tumors have the opportunity to be resected in patients with hepatocellar carcinoma (HCC) and their prognoses were acceptable. For the unrespectable HCC, however, the outcomes were rather poor because the specialty of the tumor blood supply and the tumor was insensitive to the chemotherapy drug. The objective of this study was to find sensitive drugs for individual patients and determine the safety and antitumor activity of hepatic intra-arterial and portal vein infusion chemotherapy. Methods : A total of 120 patients with the mean patient age of 56 years and with unresectable HCC were randomly divided into experimental group and control group. The experiment group was infused through an intra-arterial and portal vein catheter 3 different drugs were chosen by the results of drug sensitive test, whereas the control group was treated for TACE. The changes in tumor-size and AFP, two-step operation rate, survival rate, and complications were observed in these patients. Results: The tumor size reduced in 28(47.6 %) cases, stabilized in 14(23.3 %) cases, and progressed in 18(30 %) cases in experimental group as measured by CT or MRI after six chemotherapy cycles, whereas the corresponding data was 17(28.5 %) cases, 7(11.5 %) cases and 36(60 %) cases in the control group (P < 0.05). The AFP was declined in 51 cases in experimental group and in 30 cases in control group (P < 0.05). In the experimental group, the median follow-up time was 21 months; the overall survival rates (OS) of 6 months, 12 months, and 18 months were 86 %, 72 %, and 65 %, respectively. In the control group, the median follow-up time was 16 months; the OS rates of 6 months and 12 months were 58 % and 40 %, respectively. Six patients in the experimental group and 3 patients in the control group had two-step operation. There was no severe incidence of complications in both groups. In the experimental group, 2 (3 %) patients had wound infection, 8 cases had the chemotherapy relative diarrhea, and 18 (30 %) cases had grade Ⅰ or Ⅱ bone marrow suppression. In the control group, the chemotherapy relative diarrhea were 15 (25 %) cases and grade Ⅰ or Ⅱ bone marrow suppression were 33 (55 %) cases. Conclusion : The artery and portal vein pump transfusion chemotherapy guided by drug sensitive test was efficient for HCC treatment. The patients can get longer OS and lower complication incidence. -------------------------------------------------------- Cite this article as: Wu D, Wei S, Luo C, Wu X, Feng Y, Zhang F, Nie L, Xia X. Clinical study on the sensitivity test guided hepato-arterial/portal -vein chemotherapy in patients with unresectable hepatocellar carci-noma. Int J Cancer Ther Oncol 2014; 2(2):02029. DOI: 10.14319/ijcto.0202.9

Highlights

Because the liver tumors are not found, only less than 20% of the primary liver cancers have the opportunity to be Corresponding author: Shaozhong Wei; Cancer Hospital of Wuhan University, Zhuodaoquan South Road, Hongshan district, Wuhan, 430079, China.Cite this article as: Wu D, Wei S, Luo C, Wu X, Feng Y, Zhang F, Nie L, Xia X
Research showed that primary liver cancers have hepatic artery and portal vein dual blood supplies: blood vessel in the center of the tumor is mainly composed of hepatic artery whereas the peripheral part is mainly composed of portal vein
Patients Between October, 2010 and October, 2005, 120 cases of unresectable hepatocellar carcinoma (HCC) were randomly divided into experimental group and control group. 60 patients in the experimental group were enrolled to determine the safety and antitumor activity of hepatic intra-arterial and portal vein infusion chemotherapy; another 60 patients were enrolled in the control group

Summary

Introduction

Because the liver tumors are not found, only less than 20% of the primary liver cancers have the opportunity to be Corresponding author: Shaozhong Wei; Cancer Hospital of Wuhan University, Zhuodaoquan South Road, Hongshan district, Wuhan, 430079, China. Treatment of hepatic artery chemotherapy embolism (TACE) is one of the therapeutics available to cure the advanced stage unresectable liver cancer; the effective rate is about 30% to 40%. In order to improve the efficiency to cure primary liver cancer, scholars developed the hepatic artery/portal vein pump chemotherapy (HA/PVPC).[1] liver cancer is not aeschynomenous to chemotherapy. To improve the efficiency of individual patiens to HA/PVPC, we used individualized drug to patients based on their sensitive tests (MTT) and perfused the drugs through transartery and portal vein dual channel. We aimed to increase the regional drug concentration and improve the tumor susceptibility to drugs, improving the efficiency of liver cancer treatment

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