Department of Radiology, Taichung Armed-Forces General Hospital, Taichung 411, Taiwan.
Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan.
Medicina (Kaunas). 2021 Jul 30;57(8):779. doi: 10.3390/medicina57080779.
: To evaluate the effectiveness of hepatic arterial infusion chemotherapy (HAIC) followed by lipiodol infusion in advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT). : Thirty-two patients with advanced HCC and PVTT who received HAIC with regimens of cisplatin, mitomycin-C, and 5-fluorouracil followed by lipiodol infusion were enrolled. The primary efficacy endpoint was tumor response rate. The modified Response Evaluation Criteria in Solid Tumors (mRECIST) was used for assessment of treatment response. The secondary endpoints were overall survival (OS) and progression free survival (PFS). Prognostic factors for survival also were evaluated. : The median OS and PFS were 11.9 and 9.5 months, respectively. Seventeen patients (53.1%) achieved objective response, and 23 patients (71.9%) achieved disease control. The length of survival in the responder and disease control groups was longer than in the non-responder and progressive disease groups after two cycles of HAIC (responder vs. non-responder: 16.5 vs. 7.9 months, = 0.001; disease control vs. progressive disease: 12.3 vs. 5.6 months, < 0.001) and after completing HAIC (responder vs. non-responder: 15.7 vs. 6.9 months, = 0.001; disease control vs. progressive disease: 13.6 vs. 6.9 months, < 0.001). Better survival was associated with Child-Pugh A liver function ( = 0.013), with early response to two HAIC cycles ( = 0.009), and with response ( = 0.02) and disease control ( = 0.001) after completing HAIC treatment. HAIC followed by lipiodol infusion is a safe and feasible treatment for advanced HCC with PVTT. Patients with early response could continue HAIC treatment with expected prolonged survival.
评估顺铂、丝裂霉素 C 和氟尿嘧啶联合肝动脉化疗（HAIC）序贯碘化油栓塞治疗伴有门静脉癌栓（PVTT）的晚期肝细胞癌（HCC）的疗效。
共纳入 32 例接受顺铂、丝裂霉素 C 和氟尿嘧啶联合 HAIC 序贯碘化油栓塞治疗的晚期 HCC 合并 PVTT 患者。主要疗效终点为肿瘤缓解率。采用改良实体瘤疗效评价标准（mRECIST）评估治疗反应。次要终点为总生存期（OS）和无进展生存期（PFS）。还评估了生存的预后因素。
中位 OS 和 PFS 分别为 11.9 个月和 9.5 个月。17 例（53.1%）患者获得客观缓解，23 例（71.9%）患者疾病得到控制。在接受 2 个周期 HAIC 治疗后（缓解组 vs. 未缓解组：16.5 个月 vs. 7.9 个月， = 0.001；疾病控制组 vs. 进展组：12.3 个月 vs. 5.6 个月， < 0.001）和完成 HAIC 治疗后（缓解组 vs. 未缓解组：15.7 个月 vs. 6.9 个月， = 0.001；疾病控制组 vs. 进展组：13.6 个月 vs. 6.9 个月， < 0.001），应答者和疾病控制者的生存时间均长于无应答者和进展者。较好的生存与肝功能 Child-Pugh A（ = 0.013）、2 个 HAIC 周期早期应答（ = 0.009）以及完成 HAIC 治疗后的应答（ = 0.02）和疾病控制（ = 0.001）相关。
HAIC 序贯碘化油栓塞治疗伴有 PVTT 的晚期 HCC 是一种安全可行的治疗方法。早期应答的患者可以继续 HAIC 治疗，预期生存时间延长。
