Efficacy of Repeated Hepatic Arterial Infusion Chemotherapy in Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis

Korean J Hepatol > Volume 11(3); 2005 > Article

The Korean Journal of Hepatology 2005;11(3): 268-274.

Efficacy of Repeated Hepatic Arterial Infusion Chemotherapy in Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis

Myoung Ki Sim, M.D., Do Young Kim, M.D., Jun Yong Park, M.D., Ja Kyung Kim, M.D., Sung Ai Kim, M.D., Sang Hoon Ahn, M.D., Chae Yoon Chon, M.D., Young Myoung Moon, M.D., Jong Yun Won, M.D.1, Do-Yun Lee, M.D.1, and Kwang-Hyub Han, M.D.

Department of Internal Medicine, Institute of Gastroenterology, Yonsei Liver Cancer Clinic, Department of Diagnostic Radiology1, Yonsei University College of Medicine, Seoul, Korea

ABSTRACT

Background/Aims
The aim of this study is to elucidate the efficacy of repeated hepatic arterial infusion chemotherapy (HAIC) and different chemotherapeutic regimens for treating patients having advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). Methods: From Jan. 1999 and Dec. 2003, a total of 103 patients diagnosed as having HCC with PVTT, but without extrahepatic spreading, were enrolled in this study. They were stratified into two groups. Group I (67 patients) received intraarterial cisplatin (CDDP, 80 mg/m² for 2 hours on Day 1), Group Ⅱ (36 patients) received intraarterial CDDP (60 mg/m² for 2 hours on Day 2) and 5-fluorouracil (5-FU, 500 mg/m² for 5 hours on Day 1-3). They were scheduled to receive at least three consecutive courses of the HAIC at 1 month intervals. Results: Among the 66 patients who completed the protocol, one (2.5%) and seven (17.5%) patients of group Ⅰ, and one (3.8%) and four (15.4%) of group Ⅱ, exhibited complete and partial responses, respectively. The median survival period of all the patients was 6 months. Group Ⅱ showed a tendency to improve the median survival compared to group Ⅰ (8.5 vs 5.0 months, respectively, P=0.45). The most common adverse reaction was nausea (58.2%). However, an elevation of the total bilirubin level was more frequent in Group Ⅰ than in Group Ⅱ (61.3% vs 20.7%, respectively, P<0.05). Conclusions: Repeated HAIC using CDDP achieved favorable results in a few patients with HCC with PVTT, and additional 5-FU may be useful. (Korean J Hepatol 2005;11:268-274)

KeyWords: Hepatocellular carcinoma, Portal vein, Thrombosis, Intraarterial infusion