Efficacy of hepatic arterial infusion chemotherapy in advanced hepatocellular carcinoma  

作　　者：Yang Hyun Baek Kyoung Tae Kim Sung Wook Lee Jin Sook Jeong Byeong Ho Park Kyung Jin Nam Jin Han Cho Young Hoon Kim Young Hoon Roh Hyung Sik Lee Young Min Choi Sang Young Han 

机构地区：[1]Department of Internal Medicine,Dong-A University College of Medicine,Busan 602-103,South Korea [2]Department of Pathology,Dong-A University College of Medicine,Busan 602-103,South Korea [3]Department of Radiology,Dong-A University College of Medicine,Busan 602-103,South Korea [4]Department of Surgery,Dong-A University College of Medicine,Busan 602-103,South Korea [5]Department of Radiation Oncology,Dong-A University College of Medicine,Busan 602-103,South Korea

出　　处：《World Journal of Gastroenterology》2012年第26期3426-3434,共9页世界胃肠病学杂志（英文版）

基　　金：Supported by Dong-A University

摘　　要：AIM:To investigate the efficacy of hepatic arterial infusion chemotherapy(HAIC) using floxuridine(FUDR) in patients with advanced hepatocellular carcinoma(HCC) confined to the liver.METHODS:Thirty-four patients who had advanced HCC with unresectability or unsuccessful previous therapy in the absence of extrahepatic metastasis were treated with intra-arterial FUDR chemotherapy at ourhospital between March 2005 and May 2008.Among the 34 patients,9 patients were classified as Child class C,and 18 patients had portal vein tumor thrombus(PVTT).One course of chemotherapy consisted of continuous infusion of FUDR(0.3 mg/kg during day 1-14) and dexamethasone(10 mg on day 1,4,7 and 11),and this treatment was repeated every 28 d.RESULTS:Two patients(5.9%) displayed a complete response,and 12 patients(35.3%) had a partial response.The tumor control rate was 61.8%.The median overall survival times were 15.3 mo,12.4 mo and 4.3 mo for the patients who were classified as Child class A,Child class B and Child class C,respectively(P = 0.0392).The progression-free survival was 12.9 mo,7.7 mo and 2.6 mo for the patients who were classified as Child class A,Child class B and Child class C,respectively(P = 0.0443).The cumulative survival differed significantly according to the Child-Pugh classification and the presence of PVTT.In addition to hepatic reserve capacity and PVTT,the extent of HCC was an independent factor in determining a poor prognosis.The most common adverse reactions to HAIC were mucositis,diarrhea and peptic ulcer disease,but most of these complications were improved by medical treatment and/or a delay of HAIC.CONCLUSION:The present study demonstrates that intra-arterial FUDR chemotherapy is a safe and effective treatment for advanced HCC that is recalcitrant to other therapeutic modalities,even in patients with advanced cirrhosis.AIM：To investigate the efficacy of hepatic arterial infusion chemotherapy（HAIC） using floxuridine（FUDR） in patients with advanced hepatocellular carcinoma（HCC） confined to the liver.METHODS：Thirty-four patients who had advanced HCC with unresectability or unsuccessful previous therapy in the absence of extrahepatic metastasis were treated with intra-arterial FUDR chemotherapy at ourhospital between March 2005 and May 2008.Among the 34 patients,9 patients were classified as Child class C,and 18 patients had portal vein tumor thrombus（PVTT）.One course of chemotherapy consisted of continuous infusion of FUDR（0.3 mg/kg during day 1-14） and dexamethasone（10 mg on day 1,4,7 and 11）,and this treatment was repeated every 28 d.RESULTS：Two patients（5.9%） displayed a complete response,and 12 patients（35.3%） had a partial response.The tumor control rate was 61.8%.The median overall survival times were 15.3 mo,12.4 mo and 4.3 mo for the patients who were classified as Child class A,Child class B and Child class C,respectively（P = 0.0392）.The progression-free survival was 12.9 mo,7.7 mo and 2.6 mo for the patients who were classified as Child class A,Child class B and Child class C,respectively（P = 0.0443）.The cumulative survival differed significantly according to the Child-Pugh classification and the presence of PVTT.In addition to hepatic reserve capacity and PVTT,the extent of HCC was an independent factor in determining a poor prognosis.The most common adverse reactions to HAIC were mucositis,diarrhea and peptic ulcer disease,but most of these complications were improved by medical treatment and/or a delay of HAIC.CONCLUSION：The present study demonstrates that intra-arterial FUDR chemotherapy is a safe and effective treatment for advanced HCC that is recalcitrant to other therapeutic modalities,even in patients with advanced cirrhosis.

关 键 词：Hepatic arterial infusion chemotherapy FLOXURIDINE Advanced hepatocellular carcinoma Child-Pugh classification Portal vein tumor thrombus 

分 类 号：R735.7[医药卫生—肿瘤]