Intra-arterial chemotherapy with doxorubicin and cisplatin is effective for advanced hepatocellular cell carcinoma.

Yu-Fan Cheng,Yu-Li Su,Shau-Hsuan Li,Chen-Hua Huang,Tai-Jan Chiu,Yen-Yang Chen,Chih-Chi Wang,Kun-Ming Rau,Yen-Hao Chen,Chien-Ting Liu,Sheng-Nan Lu,Tai-Lin Huang,Ming-Chun Ma,Sung-Nan Pei

doi:10.1155/2014/160138

Abstract

Advanced hepatocellular carcinoma (HCC) remains a fatal disease even in the era of targeted therapies. Intra-arterial chemotherapy (IACT) can provide therapeutic benefits for patients with locally advanced HCC who are not eligible for local therapies or are refractory to targeted therapies. The aim of this retrospective study was to analyze the effect of IACT with cisplatin and doxorubicin on advanced HCC. Methods. Patients with advanced HCC who were not eligible for local therapies or were refractory to sorafenib received doxorubicin (50 mg/m2) and cisplatin (50 mg/m2) infusions into the liver via the transhepatic artery. Between January 2005 and December 2011, a total of 50 patients with advanced HCC received this treatment regimen. The overall response rate (ORR) was 22% in all treated patients. In patients who received at least 2 cycles of IACT, the ORR was 36.7%, and the disease control rate was 70%. Survival rate differed significantly between patients who received only one cycle of IACT (group I) and those who received several cycles (group II). The median progression-free survival was 1.3 months and 5.8 months in groups I and II, respectively (P < 0.0001). The median overall survival was 8.3 months for all patients and was 3.1 months and 12.0 months in groups I and II, respectively (P < 0.0001). The most common toxicity was alopecia. Four patients developed grade 3 or 4 leukopenia. Worsening of liver function, nausea, and vomiting were uncommon side effects. This study demonstrated clinical efficacy and tolerable side effects of repeated IACT with doxorubicin and cisplatin in advanced HCC. Our regimen can be an alternative choice for patients with adequate liver function who do not want to receive continuous infusion of IACT.

Highlights

Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third most common cause of death from cancer worldwide [1]
The major indications for Intra-arterial chemotherapy (IACT) were thrombosis in the portal vein (PVT), followed by multifocal nodules that could not be covered by transarterial embolization (TAE), and TAE failure
Six (12%) patients had extrahepatic metastasis at the time of IACT, but as their dominant symptoms were due to the primary tumors, they were deemed eligible for IACT

Summary

Introduction

Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third most common cause of death from cancer worldwide [1]. HCC is proportionately even more important in Asian countries than in the rest of the world. Approximately three-fourth of HCC cases occur in Asian countries due to the high prevalence of chronic hepatitis B virus (HBV) infection in the population [2]. Chronic HBV infection is a leading cause of HCC in most African and Asian countries with the exception of Japan [3]. In Taiwan, due to the high prevalence of HBV infection, the incidence of HCC was always the highest of all cancers, until recently it has been surpassed by colorectal cancer [5].

Methods

Results

Conclusion