Efficacy of hepatic arterial infusion chemotherapy in advanced hepatocellular carcinoma.
OBJECTIVE
To investigate the efficacy of hepatic arterial infusion chemotherapy (HAIC) using floxuridine (FUDR) in patients with advanced hepatocellular carcinoma (HCC) confined to the liver.


METHODS
Thirty-four patients who had advanced HCC with unresectability or unsuccessful previous therapy in the absence of extrahepatic metastasis were treated with intra-arterial FUDR chemotherapy at our hospital between March 2005 and May 2008. Among the 34 patients, 9 patients were classified as Child class C, and 18 patients had portal vein tumor thrombus (PVTT). One course of chemotherapy consisted of continuous infusion of FUDR (0.3 mg/kg during day 1-14) and dexamethasone (10 mg on day 1, 4, 7 and 11), and this treatment was repeated every 28 d.


RESULTS
Two patients (5.9%) displayed a complete response, and 12 patients (35.3%) had a partial response. The tumor control rate was 61.8%. The median overall survival times were 15.3 mo, 12.4 mo and 4.3 mo for the patients who were classified as Child class A, Child class B and Child class C, respectively (P = 0.0392). The progression-free survival was 12.9 mo, 7.7 mo and 2.6 mo for the patients who were classified as Child class A, Child class B and Child class C, respectively (P = 0.0443). The cumulative survival differed significantly according to the Child-Pugh classification and the presence of PVTT. In addition to hepatic reserve capacity and PVTT, the extent of HCC was an independent factor in determining a poor prognosis. The most common adverse reactions to HAIC were mucositis, diarrhea and peptic ulcer disease, but most of these complications were improved by medical treatment and/or a delay of HAIC.


CONCLUSIONS
The present study demonstrates that intra-arterial FUDR chemotherapy is a safe and effective treatment for advanced HCC that is recalcitrant to other therapeutic modalities, even in patients with advanced cirrhosis.
Department of Internal Medicine, Dong-A University College of Medicine, Busan 602-103, South Korea.
Yang Hyun
YH
Baek
Kyoung Tae
KT
Kim
Sung Wook
SW
Lee
Jin Sook
JS
Jeong
Byeong Ho
BH
Park
Kyung Jin
KJ
Nam
Jin Han
JH
Cho
Young Hoon
YH
Kim
Young Hoon
YH
Roh
Hyung Sik
HS
Lee
Young Min
YM
Choi
Sang Young
SY
Han
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy*; D003907:Dexamethasone / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D005467:Floxuridine / Q000627:therapeutic use; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000379:methods*; D008113:Liver Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome
D005467:Floxuridine; D003907:Dexamethasone