Clin Mol Hepatol.  2019 Dec;25(4):381-389. 10.3350/cmh.2019.0037.

Bi-monthly hepatic arterial infusion chemotherapy as a novel strategy for advanced hepatocellular carcinoma in decompensated cirrhotic patients

• Moriya K
• Namisaki T
• Sato S
• Furukawa M
• Douhara A
• Kawaratani H
• Kaji K
• Shimozato
• Sawada Y
• Saikawa S
• Takaya H
• Kitagawa K
• Akahane T
• Mitoro A
• Yamao J
• Yoshiji H

• KMID: 2467248
• DOI: http://doi.org/10.3350/cmh.2019.0037

Abstract

BACKGROUND AND AIMS
We previously reported the comparable efficacy of bi-monthly hepatic arterial infusion chemotherapy (B-HAIC) to that of sorafenib chemotherapy for the treatment of advanced hepatocellular carcinoma (aHCC) in patients with compensated cirrhosis. In this study, we demonstrate the efficacy of B-HAIC in patients with decompensated cirrhosis.
METHODS
Forty-five patients with aHCC refractory to transcatheter arterial chemo-embolization (TACE) were treated with B-HAIC and were divided into two groups according to hepatic functional reserve (Child-Pugh grade). Overall survival period, treatment response, and adverse events in each group were analyzed.
RESULTS
Efficacy and disease control rates in the Child-Pugh B group (n=24; 21% and 71%, respectively) were not significantly impaired compared the Child-Pugh A group (n=21; 38% and 67%, respectively). Median survival time and survival rate at 12 months in the Child-Pugh B group were 422 days and 58.3%, respectively, whereas those in the Child-Pugh A group were 567 days and 70.8%, respectively. Importantly, the hepatic functional reserve of patients did not worsen in either group during the treatment period. Furthermore, the occurrence rate of adverse events leading to discontinuation of anti-tumor treatment was not significantly increased in the Child-Pugh B group.
CONCLUSIONS
Given the preservation of hepatic functional reserve afforded by B-HAIC chemotherapy in patients with decompensated cirrhosis, B-HAIC might be an acceptable alternative strategy for aHCC patients who do not respond to TACE.

Keyword

Carcinoma, Hepatocellular; Liver cirrhosis; Cisplatin; Drug therapy; Decompensated cirrhosis

MeSH Terms

Carcinoma, Hepatocellular*
Cisplatin
Drug Therapy*
Fibrosis
Humans
Liver Cirrhosis
Survival Rate
Cisplatin