A randomized comparative study of high-dose and low-dose hepatic arterial infusion chemotherapy for intractable, advanced hepatocellular carcinoma

Woo, Hyun Young; Bae, Si Hyun; Park, Jun Yong; Han, Kwang Hyub; Chun, Ho Jong; Choi, Byung Gil; Im, Hyeon U.; Choi, Jong Young; Yoon, Seung Kew; Cheong, Jae Youn; Cho, Sung Won; Jang, Byoung Kuk; Hwang, Jae Seok; Kim, Sang Gyune; Kim, Young Seok; Seo, Yeon Seok; Yim, Hyung Joon; Um, Soon Ho

doi:10.1007/s00280-009-1126-2

Cited by 58 publications

(66 citation statements)

References 15 publications

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“…However, the ECF regimen appears to be more toxic than in previous reports of high-dose HAIC [10,14] . While grade 3 hematologic or non-hematologic toxicities comprised less than 5% in previous studies, grade 3 leukopenia, anemia, and thrombocytopenia in this study comprised 8%, 26% and 44% of the toxicities, respectively, and hepatic toxicity was higher.…”

Section: Discussioncontrasting

confidence: 46%

“…The ECF chemotherapeutic regimen in this study consisted of high dose cisplatin and 5-FU in combination with epirubicin. Woo et al [14] compared highdose HAIC with low-dose HAIC and reported that highdose HAIC was safe and achieved better tumor response compared with that of low-dose HAIC. The addition of epirubicin to the high-dose HAIC regimen resulted in more effective control of the intrahepatic tumor in our study.…”

Section: Discussionmentioning

confidence: 99%

“…The doses of chemotherapeutic agents or treatment intervals were adjusted at every treatment cycle depending on hepatic dysfunction or significant toxicity. The dose of subsequent treatment was reduced by 25% when repeated grade 2 or grade 3/4 toxicity occurred during the preceding cycle [14] .…”

Section: Chemotherapeutic Regimen and Additional Therapymentioning

confidence: 99%

“…HAIC enables anti-cancer agents to be delivered locally at high concentrations to hypervascular tumors, thereby keeping systemic concentrations of chemotherapeutic agents low due to the first-pass effect [10] . Many studies using HAIC have reported that it is a useful modality for patients with advanced HCC [10][11][12][13][14] . However, there are limited data defining the clinical factors predicting its efficacy.…”

Section: Introductionmentioning

confidence: 99%

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Hepatic arterial infusion chemotherapy in hepatocellular carcinoma with portal vein tumor thrombosis

Song

Bae²,

Song³

et al. 2013

WJG

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AIM:To evaluate the prognostic factors and efficacy of hepatic arterial infusion chemotherapy in hepatocellular carcinoma with portal vein tumor thrombosis. METHODS:Fifty hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT) were treated using hepatic arterial infusion chemotherapy (HAIC) via a subcutaneously implanted port. The epirubicin-cisplatin-5-fluorouracil (ECF) chemotherapeutic regimen consisted of 35 mg/m 2 epirubicin on day 1, 60 mg/m 2 cisplatin for 2 h on day 2, and 500 mg/m 2 5-fluorouracil for 5 h on days 1-3. The treatments were repeated every 3 or 4 wk. RESULTS:Three (6%) of the 50 patients achieved a complete response (CR), 13 (26%) showed partial responses (PR), and 22 (44%) had stable disease (SD).The median survival and time to progression were 7 and 2 mo, respectively. After 2 cycles of HAIC, CR was achieved in 1 patient (2%), PR in 10 patients (20%) and SD in 26 patients (52%). Significant pre-treatment prognostic factors were a tumor volume of < 400 cm 3 (P = 0.01) and normal levels of protein induced by vitamin K absence or antagonist (PIVKA)-Ⅱ (P = 0.022). After 2 cycles of treatment, disease control (CR + PR + SD) (P = 0.001), PVTT response (P = 0.003) and α-fetoprotein reduction of over 50% (P = 0.02) were independent factors for survival. Objective response (CR + PR), disease control, PVTT response, and combination therapy during the HAIC were also significant prognostic factors. Adverse events were tolerable and successfully managed. CONCLUSION: HAIC may be an effective treatment modality for advanced HCC with PVTT in patients with tumors < 400 cm 3 and good prognostic factors.© 2013 Baishideng. All rights reserved. Key words: Hepatocellular carcinoma; Hepatic arterial infusion chemotherapy; Portal vein tumor thrombosisCore tip: The aim of this study was to investigate the prognostic factors of hepatic arterial infusion chemotherapy in advanced hepatocellular carcinoma patients with portal vein tumor thrombosis. The primary findings of this study were as follows: (1) The median survival and time to progression were 7 and 2 mo, respectively; (2) A tumor volume of < 400 cm 3 and protein induced by vitamin K absence or antagonist-Ⅱ were independent pre-treatment prognostic factors; (3) Disease control and ≥ 50% tumor marker reduction were significant prognostic factors after the second cycle of hepatic arterial infusion chemotherapy (HAIC); and (4) Objective tumor response, disease control and portal vein tumor thrombosis response were independent post-treatment prognostic factors at the end of the HAIC. ORIGINAL ARTICLE

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Section: Discussioncontrasting

confidence: 46%

Section: Discussionmentioning

confidence: 99%

Section: Chemotherapeutic Regimen and Additional Therapymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hepatic arterial infusion chemotherapy in hepatocellular carcinoma with portal vein tumor thrombosis

Song

Bae²,

Song³

et al. 2013

WJG

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show abstract

“…A small retrospective study showed survival benefits of HAIC using low doses of cisplatin and 5-fluorouracil compared with systemic cytotoxic chemotherapy or supportive care (median survival, 6, 4, and 2 mo, respectively; P = 0.003) in cases of advanced HCC with portal vein tumor thrombosis [73] . A subsequent prospective study showed better efficacy of HAIC when a higher dose of cisplatin was used [74] . Importantly, a recent retrospective study by the same group in Korea compared HAIC and sorafenib in advanced HCC patients with portal vein tumor thrombosis and showed better overall survival (7.1 and 5.5 mo, respectively; P = 0.011) and longer median time to progression (3.3 and 2.1 mo, respectively; P = 0.034) in the HAIC group [75] .…”

Section: Medical Therapiesmentioning

confidence: 99%