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KMID : 1039320190190010038
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Journal of Liver Cancer
2019 Volume.19 No. 1 p.38 ~ p.45
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High-dose versus Low-dose 5-Fluorouracil and Cisplatin Based Hepatic Arterial Infusion Chemotherapy for Advanced Hepatocellular Carcinoma
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Lim Chae-June
Hong Ji-Yun
Ko Yang-Seok
Chung Min-Woo
Jun Chung-Hwan
Choi Sung-Kyu
Cho Sung-Bum
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Abstract
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Backgrounds/Aims: Hepatic arterial infusion chemotherapy (HAIC) has been reported as an effective treatment for advanced hepatocellular carcinoma. The aim of this study is to compare the effect and safety between a high-dose regimen (750 mg/m2 5-fluorouracil [FU] and 25 mg/m2 cisplatin on day 1-4) and a low-dose regimen (500 mg/m2 5-FU on day 1-3 with 60 mg/m2 cisplatin on day 2).
Methods: A total of 48 patients undergoing HAIC were retrospectively analyzed. Thirty-two patients were treated with the high-dose and 16 patients with the low-dose regimen.
Results: Complete response (CR), partial response (PR), stable disease (SD), and progressive disease were noted in one (3.1%), 15 (46.9%), three (9.4%), and 13 patients (40.6%) in the highdose group, and 0 (0%), one (6.3%), eight (50%), and seven patients (43.8%) in the low-dose group (p=0.002). The disease control rate (CR, PR, and SD) did not differ between groups (59.4% vs. 56.3%, p=1.000), but the objective response rate (CR and PR) was significantly higher in the high-dose group (50.0% vs. 6.3%, p=0.003). The median progression free survival did not differ between groups (4.0 vs. 6.0, p=0.734), but overall survival was significantly longer in the high-dose group (not reached vs. 16.0, p=0.028). Fourteen (43.8%) patients in the highdose group and two patients (12.5%) in the low-dose group experienced grade 3-4 toxicities (p=0.050).
Conclusions: High dose HAIC may achieve better tumor response and may improve overall survival compared to a low-dose regimen. However, the high-dose regimen should be administered cautiously because of the higher incidence of adverse events.
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KEYWORD
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Hepatocellular carcinoma, Chemotherapy, cancer, regional perfusion, Administration, metronomic
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