Hepatic Arterial Infusion Chemotherapy for Patients with Advanced Hepatocellular Carcinoma and Portal Venous Thrombosis

Abstract

Aim: Advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is associated with poor prognosis. The aim of this study was to elucidate the efficacy of hepatic arterial infusion chemotherapy (HAIC) by analyzing the clinical results of advanced HCC patients with PVTT treated in this manner in a local general hospital. Methods: 29 HCC patients with PVTT who underwent HAIC via a subcutaneously implanted injection port were enrolled as treatment group. 13 patients received supportive treatment were selected as control group. 4 courses of chemotherapy consisted of cisplatin (7 mg/m^2 infusion for 1 hour) followed by 5FU (170 mg/m^2 infusion for 5 hours)for 5 days within a given week. The prognostic factors including HAIC treatment, gender, age, Child's classification and Okuda stage were analyzed. Results: 3 patient exhibited partial response after HAIC treatment (response rate=10%). Median survival times for HAIC group and supportive treatment group were 7.9 (range, 1.9-38.7) and 1.8 (range, 0.4-5.8) months, respectively. Cox regression analysis showed that a survival advantage was associated with HAIC treatment (hazard ratio: 0.13, 95% CI: 0.04-0.41, P＜0.01) while advanced Okuda stage was associated with poor survival (hazard ratio for Okuda stage Ⅲ: 12.32, 95% CI: 1.28-118.99, P=0.03). Conclusion: HAIC may be a useful therapeutic option for treatment of advanced HCC with PVTT. Okuda stage Ⅲ patients have a low probability to obtain survival benefit.