Hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma by placing a temporary catheter via the subclavian route.
BACKGROUND
A permanent reservoir implantation is considered mandatory for hepatic arterial infusion chemotherapy (HAIC) of hepatocellular carcinoma (HCC). Since treatment sessions of HAIC may be limited for these end-staged patients, a simple alternative technique for this treatment is desirable.


OBJECTIVE
To evaluate the feasibility of placing a temporary catheter for HAIC in advanced HCC patients.


METHODS
25 advanced HCC patients underwent HAIC with drugs delivered from a temporary catheter which was placed percutaneously by puncturing the left subclavian artery under ultrasound guidance. A course of chemotherapy consisted of five consecutive daily infusions of 5-fluorouracil, cisplatin, mitomycin C, and leucovorin. The catheter was removed on the 6th day. Therapy was repeated every 4-6 weeks with maximal number of courses of up to six. The total courses of HAIC in each patient, the catheter-placed-related complications, tumor response rate, and median survival of the patients were registered.


RESULTS
A total of 77 courses of HAIC were performed with 100% technical success of catheter placement (1-6 courses in each patient, average 3.1 courses). The overall response rate was 20%, with complete response in two patients and partial response in three patients. Eleven (55%) of the 20 non-responders died within 5 months (mean HAIC, two courses). None of the patients experienced complications such as catheter occlusion, hepatic arterial thrombosis, cerebral infarction, or local infection.


CONCLUSIONS
With fewer catheter-related complications, HAIC by temporary catheter placement via subclavian puncture could be a treatment option.
Liang
Huei-Lung
HL
Department of Radiology and Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Huang
Jer-Shyung
JS
Lin
Yi-Huei
YH
Lai
Kwok-Hung
KH
Yang
Chien-Fang
CF
Pan
Huay-Ben
HB
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology; D002408:Catheters, Indwelling; D004334:Drug Administration Schedule; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome
D000970:Antineoplastic Agents