title: Evaluation of early response to hepatic arterial infusion chemotherapy in patients with advanced hepatocellular carcinoma using the combination of response evaluation criteria in solid tumors and tumor markers.
abstract: OBJECTIVE
  To assess the early response and outcome of hepatic arterial infusion chemotherapy (HAIC) in patients with advanced hepatocellular carcinoma (HCC).
  
  
  METHODS
  One hundred sixty-five HCC patients treated with HAIC were reviewed retrospectively. The early response to one course of HAIC treatment was evaluated by the Response Evaluation Criteria in Solid Tumors (RECIST) and changes in α-fetoprotein (AFP) and des-γ-carboxy prothrombin (DCP).
  
  
  RESULTS
  The median survival time (MST) for all patients was 9.5 months. The early imaging response by RECIST was assessed as partial response (PR), stable disease (SD), and progressive disease (PD) in 32 (19.3%), 86 (52.1%), and 47 (28.4%) patients, respectively. Survival correlated with early imaging response (MST in PR, 20.6; SD, 11.4; PD, 5.0 months; P < 0.0001). The MST was also significantly different in patients with AFP ratio of ≤ 1 or > 1 and DCP ratio of ≤ 1 or > 1 (worst MST, 6.5 months in patients with AFP ratio of > 1 and DCP ratio of > 1). Among patients with SD early imaging response, patients with AFP ratio of > 1 and DCP ratio of > 1 had significantly poorer survival than others (MST 7.4 vs. 12.6 months, P = 0.014). The decrease in AFP and DCP in the early stage treatment with HAIC were identified as significant and independent factors associated with survival of not only all patients, but also patients with SD early imaging response.
  
  
  CONCLUSIONS
  The use of the combination of RECIST and tumor marker ratio could be useful for assessment of the early response to HAIC and prognosis of patients with advanced HCC.
authors.affiliation: Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Miyaki
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Kawaoka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aikata
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kan
authors.forename: Hatsue
authors.initials: H
authors.lastname: Fujino
authors.forename: Takayuki
authors.initials: T
authors.lastname: Fukuhara
authors.forename: Tomoki
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Noriaki
authors.initials: N
authors.lastname: Naeshiro
authors.forename: Yohji
authors.initials: Y
authors.lastname: Honda
authors.forename: Masataka
authors.initials: M
authors.lastname: Tsuge
authors.forename: Akira
authors.initials: A
authors.lastname: Hiramatsu
authors.forename: Michio
authors.initials: M
authors.lastname: Imamura
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Hyogo
authors.forename: Yoshiiku
authors.initials: Y
authors.lastname: Kawakami
authors.forename: Rika
authors.initials: R
authors.lastname: Yoshimatsu
authors.forename: Takuji
authors.initials: T
authors.lastname: Yamagami
authors.forename: Kazuo
authors.initials: K
authors.lastname: Awai
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011498:Protein Precursors / Q000097:blood*; D011516:Prothrombin; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D014408:Biomarkers, Tumor; D011498:Protein Precursors; D000509:alpha-Fetoproteins; C008208:acarboxyprothrombin; D011516:Prothrombin
keywords: RECIST; early response; hepatic arterial infusion chemotherapy; hepatocellular carcinoma; tumor marker