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Hepatic Arterial Infusion Chemotherapy with Oxaliplatin and 5-Fluorouracil for Advanced Gallbladder Cancer

  • Clinical Investigation
  • Interventional Oncology
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to assess the safety and efficacy of hepatic arterial infusion chemotherapy (HAIC) with oxaliplatin and 5-fluorouracil for patients with advanced gallbladder cancer (GBC).

Materials and Methods

Twenty-six patients with advanced GBC, who underwent HAIC with oxaliplatin and 5-fluorouracil from January 2012 to July 2019, were enrolled in this retrospective study. The HAIC regimen consisted of infusions of oxaliplatin at 40 mg/m2 for 2 h, followed by 5-fluorouracil at 800 mg/m2 for 22 h on days 1–3 every 3–4 weeks. A maximum of six cycles of HAIC were applied for tumor control patients followed by maintenance with oral capecitabine or S-1. Overall survival (OS), progression-free survival (PFS), tumor response, and adverse events were investigated.

Results

Six of the 26 patients (23.1%) had failed systemic chemotherapy, 8/26 (30.8%) patients had failed various local therapies, and 9/26 (34.6%) patients had contraindications to systemic chemotherapy. The median OS was 13.5 months, and the median PFS was 10.0 months. The overall response rate was 69.2% (18/26), and disease control rate was 92.3% (24/26). Carcinoembryonic antigen (CEA) ≥ 10 U/ml (p = 0.003) and carbohydrate antigen 19–9 (CA19-9) ≥ 200 U/ml (p = 0.000) were independent risk factors for decreased survival. The most frequent Grade 3 or 4 treatment-related adverse event was liver dysfunction (4, 15.4%).

Conclusion

HAIC with oxaliplatin and 5-fluorouracil is an acceptable and well-tolerated treatment for advanced gallbladder cancer even for patients in whom systemic chemotherapy had failed or is contraindicated.

Level of Evidence

Level 2, Observation Study with Dramatic Effect

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Abbreviations

GBC:

Gallbladder cancer

HAIC:

Hepatic arterial infusion chemotherapy

TACE:

Trans-arterial chemoembolization

TARE:

Trans-arterial radioembolization

OS:

Overall survival

PFS:

Progression-free survival

CEA:

Carcinoembryonic antigen

CA 19-9:

Carbohydrate antigen 19-9

TBIL:

Total bilirubin

GDA:

Gastroduodenal artery

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Acknowledgements

This project was supported by National Natural Science Foundation of China (No. 81471759). We thank LetPub (www.letpub.com) for its linguistic assistance during the preparation of this manuscript.

Funding

This retrospective study was supported by National Natural Science Foundation of China (No. 81471759).

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Authors and Affiliations

  1. Department of Interventional Therapy, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), 52 Fucheng Road, Haidian District, Beijing, China

    Kanglian Zheng, Xiaodong Wang, Guang Cao, Liang Xu, Xu Zhu, Shijie Fu, Haihui Cheng & Renjie Yang

  2. Department of Biostatistics, School of Public Health, Southern Medical University, 1838 Guangzhou Avenue North, Baiyun District, Guangzhou, China

    Liqiang Fu

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  1. Kanglian Zheng
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Correspondence to Xiaodong Wang.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this retrospective study, formal consent is not required.

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Informed consent was obtained from all individual participants included in the study.

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Zheng, K., Wang, X., Cao, G. et al. Hepatic Arterial Infusion Chemotherapy with Oxaliplatin and 5-Fluorouracil for Advanced Gallbladder Cancer. Cardiovasc Intervent Radiol 44, 271–280 (2021). https://doi.org/10.1007/s00270-020-02661-9

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  • DOI: https://doi.org/10.1007/s00270-020-02661-9

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