Hepatic arterial infusion chemotherapy with epirubicin in patients with advanced hepatocellular carcinoma and portal vein tumor thrombosis.
OBJECTIVE
The objective of this study was to evaluate the antitumor, survival, and adverse effects of hepatic arterial infusion chemotherapy using epirubicin in patients with advanced hepatocellular carcinoma and portal vein tumor thrombosis.


METHODS
The study population comprised 45 consecutive patients with advanced hepatocellular carcinoma associated with tumor thrombosis in the main and/or first portal vein. A dose of 50-60 mg/m(2) epirubicin was administered from the proper, right, or left hepatic artery. Treatment was repeated every 4-12 weeks if there was no evidence of tumor progression or unacceptable toxicity.


RESULTS
Of the 45 treated patients, 4 (9%) achieved a partial response, 12 (27%) had no change, and 29 (64%) showed progressive disease. The median survival time, 1-year survival rate and median time to progression were 6.0 months, 20.0%, and 1.1 months for all patients, respectively. The main grade 3 and 4 toxicities were leukopenia (27%), neutropenia (47%), thrombocytopenia (9%), and elevation of aspartate (36%) and alanine aminotransferases (13%). Febrile neutropenia was observed in 2 patients (4%).


CONCLUSIONS
Hepatic arterial infusion chemotherapy with epirubicin is well tolerated, but appears to have little activity as a single agent in patients with hepatocellular carcinoma and portal vein tumor thrombosis.
Ikeda
Masafumi
M
Hepatobiliary and Pancreatic Oncology Division, National Cancer Center Hospital, Tokyo, Japan. masikeda@ncc.go.jp
Okusaka
Takuji
T
Ueno
Hideki
H
Morizane
Chigusa
C
Iwasa
Satoru
S
Hagihara
Atsushi
A
Kojima
Yasushi
Y
D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage* / Q000009:adverse effects; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D015251:Epirubicin / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011169:Portal Vein; D012189:Retrospective Studies; D016019:Survival Analysis; D020246:Venous Thrombosis / Q000188:drug therapy* / Q000209:etiology
D000903:Antibiotics, Antineoplastic; D015251:Epirubicin