Korean J Hepatol.
2010 Dec;16(4):355-361. 10.3350/kjhep.2010.16.4.355.
A comparative study of high-dose hepatic arterial infusion chemotherapy and transarterial chemoembolization using doxorubicin for intractable, advanced hepatocellular carcinoma
- Affiliations
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- 1Department of Internal Medicine, The Catholic University of Korea School of Medicine, Seoul, Korea. baesh@catholic.ac.kr
- 2Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
- 3Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea.
- 4Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
- 5Department of Internal Medicine, Soon Chun Hyang University College of Medicine, Seoul, Korea.
- 6Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
- KMID: 1117691
- DOI: http://doi.org/10.3350/kjhep.2010.16.4.355
Abstract
- BACKGROUND/AIMS
Transarterial chemoembolization (TACE) has long been used as a palliative therapy for unresectable hepatocellular carcinoma (HCC). High-dose hepatic arterial infusion chemotherapy (HAIC) has showed favorable outcomes in patients with intractable, advanced HCC. The aim of this study was to compare the effectiveness and safety of high-dose HAIC and conventional TACE using doxorubicin for advanced HCC.
METHODS
The high-dose HAIC group comprised 36 patients who were enrolled prospectively from six institutions. The enrollment criteria were good liver function, main portal vein invasion (including vascular shunt), infiltrative type, bilobar involvement, and/or refractory to prior conventional treatment (TACE, radiofrequency ablation, or percutaneous ethanol injection), and documented progressive disease. Patients received 5-fluorouracil (500 mg/m2 on days 1~3) and cisplatin (60 mg/m2 on day 2 every 4 weeks) via an implantable port system. In the TACE group, 31 patients with characteristics similar to those in the high-dose HAIC group were recruited retrospectively from a single center. Patients underwent a transarterial infusion of doxorubicin every 4~8 weeks.
RESULTS
Overall, 6 patients (8.9%) achieved a partial response and 20 patients (29.8%) had stable disease. The objective response rate (complete response+partial response) was significantly better in the high-dose HAIC group than in the TACE group (16.7% vs. 0%, P=0.030). Overall survival was longer in the high-dose HAIC group than in the TACE group (median survival, 193 vs. 119 days; P=0.026). There were no serious adverse effects in the high-dose HAIC group, while hepatic complications occurred more often in the TACE group.
CONCLUSIONS
High-dose HAIC appears to improve the tumor response and survival outcome compared to conventional TACE using doxorubicin in patients with intractable, advanced HCC.
Keyword
MeSH Terms
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Antibiotics, Antineoplastic/*administration & dosage
Antineoplastic Combined Chemotherapy Protocols/administration & dosage
Carcinoma, Hepatocellular/drug therapy/mortality/*therapy
Chemoembolization, Therapeutic
Cisplatin/administration & dosage
Doxorubicin/*administration & dosage
Fluorouracil/administration & dosage
Humans
Infusions, Intra-Arterial
Liver Neoplasms/drug therapy/mortality/*therapy
Magnetic Resonance Imaging
Prospective Studies
Retrospective Studies
Severity of Illness Index
Survival Rate
Tomography, X-Ray Computed
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