Article Abstract

Efficacy of bi-monthly hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma in patients with decompensated cirrhosis

Authors: Kei Moriya, Tadashi Namisaki, Shinya Sato, Masanori Furukawa, Akitoshi Douhara, Hideto Kawaratani, Kosuke Kaji, Mitsuteru Kitade, Naotaka Shimozato, Yasuhiko Sawada, Kenichiro Seki, Soichiro Saikawa, Hiroaki Takaya, Kou Kitagawa, Takemi Akahane, Akira Mitoro, Yasushi Okura, Junichi Yamao, Hitoshi Yoshiji

Abstract

Background: We have previously reported that the efficacy of bi-monthly hepatic arterial infusion chemotherapy (B-HAIC) was not inferior to that of sorafenib chemotherapy for the treatment of advanced hepatocellular carcinoma (aHCC) in patients with compensated cirrhosis. In this study, we demonstrate the efficacy of B-HAIC in patients with decompensated cirrhosis.
Methods: Forty-five patients with aHCC refractory to transcatheter arterial chemo-embolization (TACE) were treated with B-HAIC and were divided into two groups according to the grade of their hepatic functional reserve: the Child–Pugh A group (n=21) and the Child–Pugh B group (n=24). The overall survival periods, curative responses, and adverse events in each group were retrospectively analyzed.
Results: The efficacy rate and the disease control rate in the Child–Pugh B group (21% and 71%, respectively) were not significantly impaired compared with the rates in the Child–Pugh A group (38% and 67%, respectively). The median survival time and the survival rate at 12 months of patients in the Child–Pugh B group were 422 days and 58.3%, respectively, whereas those in the Child–Pugh A group were 567 days and 70.8%, respectively. Importantly, the hepatic functional reserve of patients in each group did not worsen during the treatment period. Furthermore, the occurrence rate of serious adverse events leading to discontinuation of anti-tumor treatment in both groups was quite limited despite the preserved hepatic functional reserve in these patients.
Conclusions: Given the preservation of hepatic functional reserve afforded by B-HAIC chemotherapy, even in patients with decompensated cirrhosis, we suggest that B-HAIC might be acceptable as an alternative strategy for aHCC patients who do not respond to TACE.

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