Korean J Hepatol.  2006 Mar;12(1):65-73.

Effect of Low Dose 5-Fluorouracil and Cisplatin Intra-arterial Infusion Chemotherapy in Advanced Hepatocellular Carcinoma with Decompensated Cirrhosis

• Lim TY
• Cheong JY
• Cho SW
• Sim SJ
• Kim JS
• Choi SJ
• Choi JW
• Kwon HC
• Lee KM
• Kim JK
• Won JH
• Yoo BM
• Lee KJ
• Hahm KB
• Kim JH

Abstract

BACKGROUND/AIMS: Advanced hepatocellular carcinoma (HCC) with portal vein thrombosis (PVT) has a poor prognosis. The aim of this study was to evaluate the efficacy and safety of repeated arterial infusions of low dose cisplatin and 5-fluorouracil (FU) in patients with advanced HCC with decompensated cirrhosis. METHODS: Between January 1995 and December 2003, a total of 79 decompensated cirrhotic patients having HCC and PVT were enrolled and divided into 2 groups. Group 1 (n=40) received intra-arterial infusion chemotherapy with cisplatin (10 mg for 5 days) and 5-FU (250 mg for 5 days) via an implanted chemoport every 4 weeks' and group 2 (n=39) was managed with only conservative treatment. RESULTS: The two groups were well matched with respect to the features relating to the prognosis, including age, gender and the Child- Pugh class. Although diffuse tumor involvement, main portal vein tumor thrombosis and bi-lobar involvement were more frequent in group 1, the median survival period of group 1 was significantly longer than group 2 (5 months vs. 3 months, respectively, P=0.016). Also, the 1-year survival rate of group 1 (7.5%) was higher than that of group 2 (5.1%) (P=0.016). When we analyzed the patients with the Child class B, the survival benefits of intra-arterial chemotherapy were more significant (P=0.008). CONCLUSIONS: Intra-arterial chemotherapy consisting of low dose 5-FU and cisplatin achieved favorable results for advanced HCC patients who had decompensated cirrhosis, and it showed better survival in selected patients. This therapy may be useful as a palliative treatment for HCC patients with decompensated cirrhosis.

Keyword

Liver cirrhosis; Hepatocellular carcinoma; Thrombosis, venous; Infusion; intra-arterial; Chemotherapy

MeSH Terms

Venous Thrombosis/complications
Survival Rate
Portal Vein
Palliative Care
Middle Aged
Male
Liver Neoplasms/complications/*drug therapy/mortality
Liver Cirrhosis/complications
*Infusions, Intra-Arterial
Humans
Fluorouracil/administration & dosage
Female
Disease-Free Survival
Cisplatin/administration & dosage
Carcinoma, Hepatocellular/complications/*drug therapy/mortality
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
Aged
Adult