J Liver Cancer.  2019 Mar;19(1):38-45. 10.17998/jlc.19.1.38.

High-dose versus Low-dose 5-Fluorouracil and Cisplatin Based Hepatic Arterial Infusion Chemotherapy for Advanced Hepatocellular Carcinoma

• Lim CJ
• Hong JY
• Ko YS
• Chung MW
• Jun CH
• Choi SK
• Cho SB

• KMID: 2448275
• DOI: http://doi.org/10.17998/jlc.19.1.38

Abstract

BACKGROUND/AIMS
Hepatic arterial infusion chemotherapy (HAIC) has been reported as an effective treatment for advanced hepatocellular carcinoma. The aim of this study is to compare the effect and safety between a high-dose regimen (750 mg/m2 5-fluorouracil [FU] and 25 mg/m2 cisplatin on day 1-4) and a low-dose regimen (500 mg/m2 5-FU on day 1-3 with 60 mg/m2 cisplatin on day 2).
METHODS
A total of 48 patients undergoing HAIC were retrospectively analyzed. Thirty-two patients were treated with the high-dose and 16 patients with the low-dose regimen.
RESULTS
Complete response (CR), partial response (PR), stable disease (SD), and progressive disease were noted in one (3.1%), 15 (46.9%), three (9.4%), and 13 patients (40.6%) in the highdose group, and 0 (0%), one (6.3%), eight (50%), and seven patients (43.8%) in the low-dose group (P=0.002). The disease control rate (CR, PR, and SD) did not differ between groups (59.4% vs. 56.3%, P=1.000), but the objective response rate (CR and PR) was significantly higher in the high-dose group (50.0% vs. 6.3%, P=0.003). The median progression free survival did not differ between groups (4.0 vs. 6.0, P=0.734), but overall survival was significantly longer in the high-dose group (not reached vs. 16.0, P=0.028). Fourteen (43.8%) patients in the high-dose group and two patients (12.5%) in the low-dose group experienced grade 3-4 toxicities (P=0.050).
CONCLUSIONS
High dose HAIC may achieve better tumor response and may improve overall survival compared to a low-dose regimen. However, the high-dose regimen should be administered cautiously because of the higher incidence of adverse events.

Keyword

Hepatocellular carcinoma; Chemotherapy, cancer, regional perfusion; Administration, metronomic

MeSH Terms

Administration, Metronomic
Carcinoma, Hepatocellular*
Chemotherapy, Cancer, Regional Perfusion
Cisplatin*
Disease-Free Survival
Drug Therapy*
Fluorouracil*
Humans
Incidence
Retrospective Studies
Cisplatin
Fluorouracil

Figure

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  Figure 1. Comparison of (A) progression-free survival and (B) overall survival between high-dose and low-dose regimen.

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