Therapeutic outcome of palliative chemotherapy in patients with recurrent hepatocellular carcinoma

Hepatocellular carcinoma;liver transplantation;chemotherapy;recurrence;610

의과대학 의학과 ;

University:서울대학교 대학원

关键词: Hepatocellular carcinoma;    liver transplantation;    chemotherapy;    recurrence;    610;   

Others  :  http://s-space.snu.ac.kr/bitstream/10371/132501/1/000000002742.pdf

美国|英语

来源: Seoul National University Open Repository

【 摘 要 】

Background and purpose:For patients with hepatocellular carcinoma (HCC) and liver cirrhosis, liver transplantation can be an effective treatment option for cure. However, substantial number of patients have recurrence of HCC and the prognosis is grave. The purpose of this study is to evaluate efficacy and safety of palliative chemotherapy. Methods:66 patients who received chemotherapy for recurrent HCC after liver transplantation between 2004 and 2011 were retrospectively reviewed with their electronic medical records. Chemotherapy regimens, the survival time and associated treatment options were analyzed.Results:Overall response rate to chemotherapy was 16.7%. The median progression free survival (PFS) from the first chemotherapy was 2.0 months (95% CI 1.682-2.318) and the median overall survival (OS) was 11.6 months (95% CI 7.802-15.476). Patients with LN metastasis at the initial diagnosis of recurrence had the shortest overall survival (3.1 months, p=0.005). PFS of four most common chemotherapy regimens were 1.9 months in TS1/cisplatin (n=11), 2.0 months in capecitabine/cisplatin (XP, n=10), 2.3 months in 5-fluorouracil/cisplatin (FP, n=16), and 1.8 months in sorafenib (n=21). Patients used sirolimus as an immunosuppressive agent showed a 3 month-longer survival than the others (p=0.167). Regarding chemotherapy toxicities, eight patients (12.12%) had grade 3-4 neutropenia and 2 (3.03%) experienced neutropenic fever. Three patients (4.54%) had grade 3-4 anemia and 5 (7.57%) had grade 3-4 thrombocytopenia. Grade 3-4 non-hematological toxicities were nausea, vomiting for one patient (1.51%), stomatitis (1.51%), aminotransferase elevation (1.51%), hyperbilirubinemia (1.51%), and azotemia (1.51%). Conclusion: The result of this study could be concluded that systemic palliative chemotherapy is feasible and tolerable for patients with recurrent HCC after liver transplantation. More investigations are needed to establish effective chemotherapeutic strategies for this group of patients.Key words:Hepatocellular carcinoma, liver transplantation, chemotherapy, recurrence