Department of Gastroenterology, Kanazawa University Hospital, 13-1 Takara-Machi, Kanazawa, Ishikawa, Japan.
Clin Drug Investig. 2012 Aug 8;32 Suppl 2:15-23. doi: 10.1007/BF03265493.
Hepatic arterial infusion chemotherapy (HAIC) allows the long-term administration of cytotoxic drugs to the liver. In Japan, HAIC has traditionally been used to treat patients with advanced hepatocellular carcinoma (HCC) with vascular invasion or multiple intrahepatic lesions, or both. The most common chemotherapy drugs used for HAIC in Japan are 5-fluorouracil and cisplatin. Although HAIC is associated with a high rate of response in some studies, it is not associated with a survival benefit. Furthermore, HAIC is associated with complications that are not observed with systemic chemotherapy, including peptic ulcer, arterial occlusion and port infection. A molecular targeted agent, sorafenib, recently became the standard therapy for advanced HCC on the basis of data from two randomized controlled trials. For this reason, the position of HAIC in the treatment of advanced HCC in Japan is under discussion. Clinical trials must be undertaken to establish standardized protocols and regimens for HAIC, and to determine the efficacy of HAIC in comparison with other therapies for HCC. Without evidence from such trials, HAIC may not find an established role in the treatment of HCC, and may even fall out of use. Recent evidence suggests that HAIC may be useful in combination with molecular targeted therapy; this is currently being investigated in a number of clinical trials.
肝动脉灌注化疗（HAIC）允许长期向肝脏给予细胞毒性药物。在日本，HAIC 传统上用于治疗有血管侵犯或多发肝内病变，或二者均有的晚期肝细胞癌（HCC）患者。日本用于 HAIC 的最常见化疗药物为氟尿嘧啶和顺铂。尽管一些研究中 HAIC 与高应答率相关，但与生存获益无关。此外，HAIC 与系统化疗中不观察到的并发症相关，包括消化性溃疡、动脉闭塞和端口感染。一种分子靶向药物索拉非尼，基于两项随机对照试验的数据，最近成为晚期 HCC 的标准治疗。由于这个原因，HAIC 在日本治疗晚期 HCC 的地位正在讨论中。必须开展临床试验来建立 HAIC 的标准化方案和方案，并确定与 HCC 的其他治疗方法相比 HAIC 的疗效。没有来自这些试验的证据，HAIC 在 HCC 的治疗中可能找不到既定的作用，甚至可能不再使用。最近的证据表明，HAIC 可能与分子靶向治疗联合有用；目前正在一些临床试验中进行研究。
