title: Long-term clinical outcomes of hepatic arterial infusion chemotherapy with cisplatin with or without 5-fluorouracil in locally advanced hepatocellular carcinoma.
abstract: Hepatic arterial infusion chemotherapy (HAIC) has often been used as a therapeutic option for patients with advanced hepatocellular carcinoma (HCC). This study aimed to evaluate the efficacy and safety of HAIC using cisplatin with or without 5-fluorouracil in patients with advanced HCC.
  
  
  
  Between January 2002 and December 2007, we enrolled patients with advanced HCC who underwent HAIC via implantable port systems with cisplatin (60 mg/m(2) on Day 1) with or without 5-fluorouracil (500 mg/m(2) on Days 1-3) every 4 weeks. Tumor response was assessed every two cycles.
  
  
  
  During follow-up (median 9.5 months), we recorded patient (n = 138) and disease characteristics including median age (53 years), Child-Pugh class A/B (n = 103/35, respectively), portal vein thrombosis (n = 115), and death (n = 121). In total, 561 cycles of HAIC were administered (median four cycles, range 1-14). Ninety-one patients received cisplatin plus 5-fluorouracil, while 47 received only cisplatin. The median progression-free survival (PFS) and overall survival (OS) were 6.0 and 9.5 months, respectively, while the overall disease control rate was 62.3% (3 complete responses, 29 partial responses and 54 stable diseases). Patients treated with cisplatin plus 5-fluorouracil had longer median PFS (7.0 vs. 4.6 months in those given cisplatin only; p = 0.004) and OS (12.0 vs. 7.5 months in those given cisplatin only; p = 0.001). Adverse reactions were tolerable and successfully managed with conservative treatment.
  
  
  
  Repetitive HAIC seems well-tolerated and effective in treating advanced HCC, with more therapeutic benefit when treated with cisplatin plus 5-fluorouracil. Future randomized comparative studies are warranted for its efficacy.
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Korea.
authors.forename: Beom Kyung
authors.initials: BK
authors.lastname: Kim
authors.forename: Jun Yong
authors.initials: JY
authors.lastname: Park
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Choi
authors.forename: Do Young
authors.initials: DY
authors.lastname: Kim
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Ahn
authors.forename: Ja Kyung
authors.initials: JK
authors.lastname: Kim
authors.forename: Do Youn
authors.initials: DY
authors.lastname: Lee
authors.forename: Kwang Hoon
authors.initials: KH
authors.lastname: Lee
authors.forename: Kwang-Hyub
authors.initials: KH
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin; D005472:Fluorouracil