Jay Chun Chang

Hepatic arterial infusion chemotherapy using high-dose 5-fluorouracil and cisplatin with or without interferon-α for the treatment of advanced hepatocellular carcinoma with portal vein tumor thrombosis

Abstract Objective. In this retrospective study, we assessed the efficacy of hepatic arterial infusion chemotherapy (HAIC) using high-dose 5-fluorouracil (5-FU) and cisplatin with or without interferon (IFN)-α for the treatment of advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombosis. Material and methods. Fifty-two patients were included in the analysis. The patients were treated with 5-FU (750 mg/m2) and cisplatin (25 mg/m2) from Days 1 to 4. IFN-α was administered subcutaneously at a dose of 3 million units from Days 1 to 4, and then every other day for 24 days. Chemotherapy was repeated every 4 weeks. Thirty-one patients were treated with 5-FU, cisplatin and IFN-α (FPI group) and 21 were treated with 5-FU and cisplatin (FP group). Results. An objective tumor response was achieved in six patients (19.4%) in the FPI group. In the FP group, 12 patients (57.1%) achieved an objective tumor response (p = 0.015). The cumulative survival rate was higher in the FP group than the FPI group, but this difference was not statistically significant (p = 0.353). The median survival time for the 18 responders was 14 months (range 4–25 months), and their 6, 12, and 24-month cumulative survival rates were 89%, 83%, and 25%, respectively. Conclusions. HAIC using high-dose 5-FU plus cisplatin achieved a good tumor response. Adding IFN-α did not show any additional beneficial effects in terms of tumor response rate or survival.

Pathological complete remission of advanced hepatocellular carcinoma with main portal vein tumor thrombosis by hepatic arterial infusion chemotherapy.

Cures for advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) are rare and difficult. We report a case of pathologically confirmed complete remission of HCC induced by hepatic arterial infusion chemotherapy (HAIC). A 45-year-old male patient had a massive HCC in the right lobe of the liver and tumor thrombus in the right and main portal veins. He achieved a partial response after two cycles of HAIC with 5-fluorouracil (750 mg/m(2)) and cisplatin (25 mg/m(2)). After the completion of six cycles he received a curative partial hepatectomy, and histopathology revealed complete necrosis without any viable tumor cell. He was in good health at a 4-month follow-up. These results suggest that this regimen is a promising therapeutic modality for the treatment of advanced HCC with PVTT.