Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan.
Liver Int. 2013 Oct;33(9):1413-9. doi: 10.1111/liv.12207. Epub 2013 May 28.
BACKGROUND & AIMS: For patients with advanced hepatocellular carcinoma (HCC) who have failed first-line anti-angiogenic therapy, there is no salvage treatment. Hepatic arterial infusion of chemotherapy (HAIC) has been reported to achieve substantial treatment responses in HCC patients. We aimed to explore the feasibility of using HAIC as second-line therapy for advanced HCC.
We retrospectively reviewed all consecutive patients who received HAIC for advanced HCC after failure of first-line anti-angiogenic therapy at a single institute. Patients received HAIC with 60 mg/m(2) cisplatin on Day 2, and 500 mg/m(2) /d dose of 5-fluorouracil on Days 1-3. The treatment was repeated every 21 days and continued until disease progression or the occurrence of intolerable toxicities. Tumour assessment was performed after every 3 cycles of HAIC following RECIST criteria, version 1.0.
A total of 23 patients were included. Eleven (48%) patients had main portal vein thrombosis. Liver reserve was classified as Child-Pugh A in 19 (83%) patients and B in 4 (17%) patients. No complete response was observed, although 6 (26%) patients showed partial responses. The median progression-free survival was 4.4 months, and the median overall survival was 7.5 months. Common toxicities included bone marrow suppression, elevated transaminase levels, neutropenia, nausea and malaise. Only 7 (30%) patients experienced grade 3 or 4 toxicities, and no patients withdrew from the therapy because of intolerable or life-threatening toxicities.
HAIC is a feasible second-line therapy for patients with advanced HCC who have failed anti-angiogenic therapy.
对于一线抗血管生成治疗失败的晚期肝细胞癌（HCC）患者，尚无挽救性治疗方法。已有报道称，肝动脉灌注化疗（HAIC）可使 HCC 患者获得显著的治疗反应。本研究旨在探讨将 HAIC 作为一线抗血管生成治疗失败的晚期 HCC 二线治疗的可行性。
我们回顾性分析了在一家单中心接受 HAIC 治疗的所有一线抗血管生成治疗失败的晚期 HCC 患者。患者接受 60mg/m²顺铂（第 2 天）和 500mg/m²/d 氟尿嘧啶（第 1-3 天）的 HAIC 治疗。每 21 天重复治疗，直至疾病进展或出现无法耐受的毒性。根据 RECIST 标准（版本 1.0），在 HAIC 每 3 个周期后评估肿瘤。
共纳入 23 例患者。11 例（48%）患者存在主门静脉血栓形成。19 例（83%）患者的肝脏储备功能为 Child-Pugh A 级，4 例（17%）患者为 B 级。尽管 6 例（26%）患者表现出部分缓解，但未观察到完全缓解。中位无进展生存期为 4.4 个月，中位总生存期为 7.5 个月。常见的毒性包括骨髓抑制、转氨酶升高、中性粒细胞减少、恶心和不适。仅 7 例（30%）患者发生 3 级或 4 级毒性，无患者因无法耐受或危及生命的毒性而退出治疗。
HAIC 是一线抗血管生成治疗失败的晚期 HCC 患者的一种可行的二线治疗方法。
