[Intra-arterial chemotherapy for the treatment of advanced hepatocellular carcinoma through implantable port (reservoir)].
In this study, we evaluated the effectiveness of the arterial infusion chemotherapy through an implantable port for the treatment of advanced hepatocellular carcinoma. The chemotherapy comprised weekly or biweekly administrations of epi-ADM combined with 5-FU and MMC. The patients were divided into 4 groups as follows: 1) 37 patients treated mainly by repeat transcatheter arterial embolization (TAE) (TAE group); 2) 16 patients treated by arterial infusion chemotherapy through implantable port after TAE (TAE-RV group); 3) 9 patients with no indication for TAE treated by one-shot arterial infusion chemotherapy (one-shot group); and 4) 13 patients with no indication for TAE treated by arterial infusion chemotherapy through an implantable port (RV group). The median survival after the complete courses of TAE was 23 weeks in the TAE group, and 59 weeks in the TAE-RV group. There was a statistically significant difference in median survival time between the TAE group and the TAE-RV group (p < 0.01). On the other hand, the median survival time after the initial administration of an anticancer agent was 9 weeks in the one-shot group and 24 weeks in the RV group. There was also a statistically significant difference in median survival between the one-shot group and the RV group (p < 0.01). In the RV group, the 30-day mortality after the initial arterial infusion chemotherapy was 23.1% (3 patients). Two of these 3 patients showed a poor clinical status with uncontrollable ascites at the beginning of this study. In conclusion, arterial infusion chemotherapy through implantable port was evaluated as effective for the treatment of advanced hepatocellular carcinoma in patients with no indication for TAE, but the indication of this therapy remained subject for further evaluation.
Dept. of Radiology, Kochi Municipal Central Hospital.
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Motohara
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Ozawa
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Morita
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D004334:Drug Administration Schedule; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D015918:Infusion Pumps, Implantable; D007261:Infusions, Intra-Arterial; D007269:Injections, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D016019:Survival Analysis
D015251:Epirubicin; D016685:Mitomycin; D005472:Fluorouracil