Hepatic Arterial Infusion Chemotherapy with Epirubicin in Patients with Advanced Hepatocellular Carcinoma and Portal Vein Tumor Thrombosis

Abstract

Objective: The objective of this study was to evaluate the antitumor, survival, and adverse effects of hepatic arterial infusion chemotherapy using epirubicin in patients with advanced hepatocellular carcinoma and portal vein tumor thrombosis. Methods: The study population comprised 45 consecutive patients with advanced hepatocellular carcinoma associated with tumor thrombosis in the main and/or first portal vein. A dose of 50–60 mg/m² epirubicin was administered from the proper, right, or left hepatic artery. Treatment was repeated every 4–12 weeks if there was no evidence of tumor progression or unacceptable toxicity. Results: Of the 45 treated patients, 4 (9%) achieved a partial response, 12 (27%) had no change, and 29 (64%) showed progressive disease. The median survival time, 1-year survival rate and median time to progression were 6.0 months, 20.0%, and 1.1 months for all patients, respectively. The main grade 3 and 4 toxicities were leukopenia (27%), neutropenia (47%), thrombocytopenia (9%), and elevation of aspartate (36%) and alanine aminotransferases (13%). Febrile neutropenia was observed in 2 patients (4%). Conclusion: Hepatic arterial infusion chemotherapy with epirubicin is well tolerated, but appears to have little activity as a single agent in patients with hepatocellular carcinoma and portal vein tumor thrombosis.