Efficacy and safety of hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma as first-line therapy.

Efficacy and safety of hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma as first-line therapy.
antineoplastic agent; cisplatin; fluorouracil; adult; aged; anemia; article; Child-Pugh class; diarrhea; disease free survival; drug combination; female; hepatic arterial infusion chemotherapy; human; intraarterial drug administration; Kaplan Meier method; liver cell carcinoma; liver tumor; male; middle aged; neutropenia; overall survival; Progression-free survival; retrospective study; severity of illness index; thrombocytopenia; treatment outcome; Carcinoma, Hepatocellular; Child-Pugh class; Hepatic arterial infusion chemotherapy; Overall survival; Progression-free survival; Adult; Aged; Anemia; Antineoplastic Agents; Carcinoma, Hepatocellular; Cisplatin; Diarrhea; Disease-Free Survival; Drug Therapy, Combination; Female; Fluorouracil; Humans; Infusions, Intra-Arterial; Kaplan-Meier Estimate; Liver Neoplasms; Male; Middle Aged; Neutropenia; Retrospective Studies; Severity of Illness Index; Thrombocytopenia; Treatment Outcome
Issue Date
Clinical and molecular hepatology, v.19, no.3, pp.288 - 299
Hepatic arterial infusion chemotherapy (HAIC) with 5-fluorouracil and cisplatin for intractable advanced hepatocellular carcinoma (HCC) may have survival benefits. We aimed to determine the efficacy and safety of HAIC for advanced HCC as first-line therapy. A total of 54 patients who received only HAIC with 5-fluorouracil (750 mg/m(2) on days 1-4) and cisplatin (25 mg/m(2) on days 1-4) for advanced HCC from Jan. 2009 to Dec. 2011 were selected. According to Child-Pugh class, the overall survival (OS), progression-free survival (PFS), and adverse events after HAIC were investigated retrospectively. Median OS and PFS between the Child-Pugh A group (n=24) and the Child-Pugh B/C group (n=30) were 8.7 (95% confidence interval [CI]: 4.7-12.7) vs. 3.7 months (95% CI: 2.0-5.3), and 7.1 (95% CI: 3.8-10.4) vs. 3.6 months (95% CI: 2.0-5.2), respectively. Although median OS and PFS were not statistically significant between the two groups (P=0.079, P=0.196), the Child-Pugh class B/C tended to influence poor OS. Serious adverse events �� grade 3 occurred frequently in both groups (83.3 vs. 96.7%, P=0.159). Responders (22.2%, complete or partial response) significantly differed in median OS, compared to non-responders (13.1 vs. 4.4 months, P=0.019). Achievement of complete or partial response was an independent prognostic factor of OS (hazard ratio: 0.4, 95% CI: 0.2-0.8, P=0.011). Achievement of response after HAIC provide a survival benefit in patients with advanced HCC, but HAIC should be administered cautiously in patients with Child-Pugh class B/C, because of a relatively low survival and high incidence of serious adverse events.
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