Author:
Naruto Kensuke,Kawaoka Tomokazu,Kodama Kenichiro,Ogawa Yutaro,Amioka Kei,Yoshikawa Yuki,Kikukawa Chihiro,Suehiro Yousuke,Yamaoka Kenji,Ando Yuwa,Kosaka Yumi,Uchikawa Shinsuke,Nakahara Takashi,Murakami Eisuke,Ono Atsushi,Uchida Takuro,Yamauchi Masami,Okamoto Wataru,Takahashi Shoichi,Imamura Michio,Chosa Keigo,Awai Kazuo,Kubo Katsumaro,Nagata Yasushi,Chayama Kazuaki,Aikata Hiroshi
Abstract
Abstract
Background
Patients with hepatocellular carcinoma (HCC) and macrovascular invasion (MVI) who receive systemic chemotherapy have a poor prognosis. This study aimed to determine if one-shot cisplatin (CDDP) chemotherapy via hepatic arterial infusion (HAI) combined with radiation therapy (RT) prior to systemic chemotherapy could improve the outcomes of these patients.
Methods
This study consisted of 32 HCC patients with the following eligibility criteria: (i) portal vein invasion 3/4 and/or hepatic vein invasion 2/3; (ii) received one-shot CDDP via HAI; (iii) received RT for MVI, (iv) a Child–Pugh score ≤ 7; and (v) an Eastern Clinical Oncology Group Performance Status score of 0 or 1. To determine the therapeutic effect, we collected information on patient characteristics and took contrast-enhanced computed tomography at the start of the therapy and every 2 to 4 months after the start of therapy. We evaluated the overall response of the tumor and tumor thrombosis according to modified Response Evaluation Criteria in Solid Tumors. We assessed patient data using the Mann–Whitney U and Fisher exact tests and evaluated overall survival and progression-free survival using the log-rank test.
Results
The overall response rate at the first evaluation performed a median of 1.4 weeks after HAI was 16% for the main intrahepatic tumor and 59% for the MVI. The best responses were the same as those of the first-time responses. The duration of median survival was 8.6 months, and progression-free survival of the main intrahepatic tumor was 3.2 months. Predictive factors for overall survival were the relative tumor volume in the liver and the first therapeutic response of MVI. There were no severe adverse events or radiation-induced hepatic complications.
Conclusions
One-shot CDDP via HAI and RT were well tolerated and showed immediate and favorable control of MVI. Thus, this combination shows potential as a bridging therapy to systemic chemotherapy.
Publisher
Springer Science and Business Media LLC
Subject
Gastroenterology,General Medicine
Cited by
1 articles.
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