Bi-monthly hepatic arterial infusion chemotherapy as a novel strategy for advanced hepatocellular carcinoma in decompensated cirrhotic patients

Clinical and Molecular Hepatology

Junichi Yamao¹  Akira Mitoro²  Hitoshi Yoshiji²  Naotaka Shimozato²  Hideto Kawaratani²  Kei Moriya²  Kosuke Kaji²  Tadashi Namisaki²  Masanori Furukawa²  Koh Kitagawa²  Akitoshi Douhara²  Shinya Sato²  Soichiro Saikawa²  Takemi Akahane²  Hiroaki Takaya²  Yasuhiko Sawada² 

[1] Department of Endoscopy, Nara Medical University, Kashihara, Japan;Division of Gastroenterology and Hepatology, Third Department of Internal Medicine, Nara Medical University, Kashihara, Japan;

关键词: carcinoma, hepatocellular;    liver cirrhosis;    cisplatin;    drug therapy;    decompensated cirrhosis;   

DOI  :  10.3350/cmh.2019.0037

来源: DOAJ

【 摘 要 】

Background and Aims We previously reported the comparable efficacy of bi-monthly hepatic arterial infusion chemotherapy (B-HAIC) to that of sorafenib chemotherapy for the treatment of advanced hepatocellular carcinoma (aHCC) in patients with compensated cirrhosis. In this study, we demonstrate the efficacy of B-HAIC in patients with decompensated cirrhosis. Methods Forty-five patients with aHCC refractory to transcatheter arterial chemo-embolization (TACE) were treated with B-HAIC and were divided into two groups according to hepatic functional reserve (Child-Pugh grade). Overall survival period, treatment response, and adverse events in each group were analyzed. Results Efficacy and disease control rates in the Child-Pugh B group (n=24; 21% and 71%, respectively) were not significantly impaired compared the Child-Pugh A group (n=21; 38% and 67%, respectively). Median survival time and survival rate at 12 months in the Child-Pugh B group were 422 days and 58.3%, respectively, whereas those in the Child-Pugh A group were 567 days and 70.8%, respectively. Importantly, the hepatic functional reserve of patients did not worsen in either group during the treatment period. Furthermore, the occurrence rate of adverse events leading to discontinuation of anti-tumor treatment was not significantly increased in the Child-Pugh B group. Conclusions Given the preservation of hepatic functional reserve afforded by B-HAIC chemotherapy in patients with decompensated cirrhosis, B-HAIC might be an acceptable alternative strategy for aHCC patients who do not respond to TACE.

【 授权许可】

Unknown