Osuga Keigo, Murakami Takamichi, Nakata Saki, Tomoda Kaname, Nagano Hiroaki, Monden Morito, Nakamura Hironobu
Dept. of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Gan To Kagaku Ryoho. 2004 Dec;31(13):2114-7.
Hepatic arterial infusion chemotherapy (HAIC) has been often selected as a therapeutic option for advanced hepatocellular carcinoma (HCC) with intrahepatic metastases or portal vein thrombosis, which is not eligible for hepatic resection, tumor ablation, or embolization. Among various regimens, HAIC, consisting of 5-fluorouracil (5-FU) in combination with either low-doses of cisplatin (CDDP) or interferon-alpha has been reported to improve the response rates for advanced HCC. As both regimens require the use of an implanted port-catheter system, maintaining the patency of hepatic arteries is an important factor for the intrahepatic drug distribution and the efficacy of HAIC. Recently, a new product, CDDP powder has been also developed for intraarterial use, which adds a new option to HAIC. However, the long-term outcome or the survival benefit remains unclear with HAIC, and it may be significantly affected by liver function and cirrhosis. None of the regimens have been proved to be the standard for HAIC, and prospective multi-center clinical studies with standardized protocol are needed in the future.
肝动脉灌注化疗（HAIC）常被选为治疗伴有肝内转移或门静脉血栓形成的晚期肝细胞癌（HCC）的一种治疗选择，这类患者不符合肝切除、肿瘤消融或栓塞的条件。在各种治疗方案中，据报道，由5-氟尿嘧啶（5-FU）联合低剂量顺铂（CDDP）或α-干扰素组成的HAIC可提高晚期HCC的缓解率。由于这两种方案都需要使用植入式导管系统，维持肝动脉通畅是肝内药物分布和HAIC疗效的一个重要因素。最近，一种新产品顺铂粉末也已开发用于动脉内使用，这为HAIC增加了一个新的选择。然而，HAIC的长期疗效或生存获益仍不明确，并且可能受到肝功能和肝硬化的显著影响。目前尚无一种方案被证明是HAIC的标准方案，未来需要开展具有标准化方案的前瞻性多中心临床研究。
