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KMID : 1040620190250040381
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Clinical and Molecular Hepatology
2019 Volume.25 No. 4 p.381 ~ p.389
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Bi-monthly hepatic arterial infusion chemotherapy as a novel strategy for advanced hepatocellular carcinoma in decompensated cirrhotic patients
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Moriya Kei
Namisaki Tadashi
Sato Shinya
Furukawa Masanori
Douhara Akitoshi
Kawaratani Hideto
Kaji Kosuke
Shimozato Naotaka
Sawada Yasuhiko
Saikawa Soichiro
Takaya Hiroaki
Kitagawa Koh
Akahane Takemi
Mitoro Akira
Yamao Junichi
Yoshiji Hitoshi
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Abstract
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Background and Aims: We previously reported the comparable efficacy of bi-monthly hepatic arterial infusion chemotherapy (B-HAIC) to that of sorafenib chemotherapy for the treatment of advanced hepatocellular carcinoma (aHCC) in patients with compensated cirrhosis. In this study, we demonstrate the efficacy of B-HAIC in patients with decompensated cirrhosis.
Methods: Forty-five patients with aHCC refractory to transcatheter arterial chemo-embolization (TACE) were treated with B-HAIC and were divided into two groups according to hepatic functional reserve (Child-Pugh grade). Overall survival period, treatment response, and adverse events in each group were analyzed.
Results: Efficacy and disease control rates in the Child-Pugh B group (n=24; 21% and 71%, respectively) were not significantly impaired compared the Child-Pugh A group (n=21; 38% and 67%, respectively). Median survival time and survival rate at 12 months in the Child-Pugh B group were 422 days and 58.3%, respectively, whereas those in the Child-Pugh A group were 567 days and 70.8%, respectively. Importantly, the hepatic functional reserve of patients did not worsen in either group during the treatment period. Furthermore, the occurrence rate of adverse events leading to discontinuation of anti-tumor treatment was not significantly increased in the Child-Pugh B group.
Conclusions: Given the preservation of hepatic functional reserve afforded by B-HAIC chemotherapy in patients with decompensated cirrhosis, B-HAIC might be an acceptable alternative strategy for aHCC patients who do not respond to TACE.
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KEYWORD
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Carcinoma, Hepatocellular, Liver cirrhosis, Cisplatin, Drug therapy, Decompensated cirrhosis
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