Tajiri Kazuto, Kawai Kengo, Minemura Masami, Yasumura Satoshi, Hosokawa Ayumu, Kawabe Hideto, Tomizawa Gakuto, Sugiyama Toshiro
The Third Department of Internal Medicine, Toyama University Hospital, Toyama, Japan.
Department of Radiology, Toyama University Hospital, Toyama, Japan.
Hepatol Res. 2015 Jul;45(7):755-63. doi: 10.1111/hepr.12417. Epub 2014 Oct 9.
Hepatic arterial infusion (HAIC) therapy may be a therapeutic option for advanced hepatocellular carcinoma (HCC) in addition to administration of sorafenib, which is the only currently established standard regimen for this disease. Survival benefit of HAIC has been reported in patients positive for antitumor response. Therefore, the prediction of antitumor response is important in decision-making for HAIC treatment.
Twenty-six consecutive patients with advanced HCC treated by HAIC using arterial cisplatin plus continuous 5-fluorouracil were retrospectively analyzed in this study. Neutrophil/lymphocyte ratio (NLR) was assessed to determine its effectiveness as a prognostic indicator of HAIC.
The median time to progression and overall survival time (OS) were 5.0 and 17.0 months, respectively. The overall response rate (RR) among the 26 patients was 42.3%, and RR was independent of liver function. Interestingly, RR was significantly lower in patients with NLR of 4 or more (odds ratio, 0.49; P = 0.04). When we investigated factors that influenced OS, treatment effect and NLR of less than 4 were associated with prolonged OS. No serious adverse events were found in treatment with HAIC.
HAIC is a candidate for treatment of advanced HCC, and NLR may be a useful prognostic indicator for suitability of HAIC.
肝动脉灌注化疗（HAIC）可能是晚期肝细胞癌（HCC）的一种治疗选择，除此之外还有索拉非尼给药，索拉非尼是目前唯一已确立的针对该疾病的标准治疗方案。已有报道称HAIC对有抗肿瘤反应的患者有生存获益。因此，预测抗肿瘤反应对于HAIC治疗的决策很重要。
本研究回顾性分析了连续26例采用动脉顺铂加持续5-氟尿嘧啶进行HAIC治疗的晚期HCC患者。评估中性粒细胞/淋巴细胞比值（NLR），以确定其作为HAIC预后指标的有效性。
中位疾病进展时间和总生存时间（OS）分别为5.0个月和17.0个月。26例患者的总缓解率（RR）为42.3%，且RR与肝功能无关。有趣的是，NLR为4或更高的患者RR显著较低（比值比，0.49；P = 0.04）。当我们研究影响OS的因素时，治疗效果和NLR小于4与OS延长相关。HAIC治疗未发现严重不良事件。
HAIC是晚期HCC治疗的候选方案，NLR可能是HAIC适用性的有用预后指标。
