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Korean J Hepatol > Volume 12(1); 2006 > Article
The Korean Journal of Hepatology 2006;12(1): 65-73.
Effect of Low Dose 5-Fluorouracil and Cisplatin Intra-arterial Infusion Chemotherapy in Advanced Hepatocellular Carcinoma with Decompensated Cirrhosis
Tae Young Lim, M.D., Jae Youn Cheong, M.D., Sung Won Cho, M.D., Sung Jun Sim, M.D., Jong Su Kim, M.D., Sung Jun Choi, M.D., Jeong Woo Choi, M.D., Hyeok Choon Kwon, M.D., Kee Myung Lee, M.D., Jai Keun Kim, M.D.1, Je Hwan Won, M.D.1, Byung Moo Yoo, M.D., Kwang Jae Lee, M.D., Ki Baik Hahm, M.D. and Jin Hong Kim, M.D.
Department of Gastroenterology, Genomic Research Center for Gastroenterology, Department of Diagnostic Radiology1, Ajou University School of Medicine, Suwon, South Korea

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.
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.
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).
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. (Korean J Hepatol 2006;12: 65-73)
KeyWords: Liver cirrhosis; Hepatocellular carcinoma; Thrombosis, venous; Infusion, intra-arterial; Chemotherapy
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