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Long-term clinical outcomes of hepatic arterial infusion chemotherapy with cisplatin with or without 5-fluorouracil in locally advanced hepatocellular carcinoma

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Abstract

Purpose

Hepatic arterial infusion chemotherapy (HAIC) has often been used as a therapeutic option for patients with advanced hepatocellular carcinoma (HCC). This study aimed to evaluate the efficacy and safety of HAIC using cisplatin with or without 5-fluorouracil in patients with advanced HCC.

Methods

Between January 2002 and December 2007, we enrolled patients with advanced HCC who underwent HAIC via implantable port systems with cisplatin (60 mg/m2 on Day 1) with or without 5-fluorouracil (500 mg/m2 on Days 1–3) every 4 weeks. Tumor response was assessed every two cycles.

Results

During follow-up (median 9.5 months), we recorded patient (n = 138) and disease characteristics including median age (53 years), Child-Pugh class A/B (n = 103/35, respectively), portal vein thrombosis (n = 115), and death (n = 121). In total, 561 cycles of HAIC were administered (median four cycles, range 1–14). Ninety-one patients received cisplatin plus 5-fluorouracil, while 47 received only cisplatin. The median progression-free survival (PFS) and overall survival (OS) were 6.0 and 9.5 months, respectively, while the overall disease control rate was 62.3% (3 complete responses, 29 partial responses and 54 stable diseases). Patients treated with cisplatin plus 5-fluorouracil had longer median PFS (7.0 vs. 4.6 months in those given cisplatin only; p = 0.004) and OS (12.0 vs. 7.5 months in those given cisplatin only; p = 0.001). Adverse reactions were tolerable and successfully managed with conservative treatment.

Conclusions

Repetitive HAIC seems well-tolerated and effective in treating advanced HCC, with more therapeutic benefit when treated with cisplatin plus 5-fluorouracil. Future randomized comparative studies are warranted for its efficacy.

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Acknowledgments

This study was supported by the Liver Cirrhosis Clinical Research Center, in part by a grant from the Brain Korea 21 Project for Medical Science, and also by a grant from the Ministry for Health, Welfare and Family Affairs, Republic of Korea (no. A050021).

Conflict of interest statement

There is no conflict of interest to report regarding this article.

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Authors and Affiliations

  1. Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul, 120-752, Korea

    Beom Kyung Kim, Jun Yong Park, Hye Jin Choi, Do Young Kim, Sang Hoon Ahn, Ja Kyung Kim & Kwang-Hyub Han

  2. Yonsei Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea

    Jun Yong Park, Hye Jin Choi, Do Young Kim, Sang Hoon Ahn, Ja Kyung Kim & Kwang-Hyub Han

  3. Department of Radiology, Yonsei University College of Medicine, Seoul, Korea

    Do Youn Lee & Kwang Hoon Lee

  4. Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea

    Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Ja Kyung Kim & Kwang-Hyub Han

  5. Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea

    Kwang-Hyub Han

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  1. Beom Kyung Kim
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  2. Jun Yong Park
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Correspondence to Kwang-Hyub Han.

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Kim, B.K., Park, J.Y., Choi, H.J. et al. Long-term clinical outcomes of hepatic arterial infusion chemotherapy with cisplatin with or without 5-fluorouracil in locally advanced hepatocellular carcinoma. J Cancer Res Clin Oncol 137, 659–667 (2011). https://doi.org/10.1007/s00432-010-0917-5

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  • DOI: https://doi.org/10.1007/s00432-010-0917-5

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