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Cancer 2002 Aug 1;95(3):588-95 Related Articles, Links  

  
Hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma with portal vein tumor thrombosis: analysis of 48 cases.

Ando E, Tanaka M, Yamashita F, Kuromatsu R, Yutani S, Fukumori K, Sumie S, Yano Y, Okuda K, Sata M.

Department of Medicine II, Kurume University School of Medicine, 67 Asahi-Machi, Kurume-shi, Fukuoka-ken 830-0011, Japan. [email protected]

BACKGROUND: The prognosis of patients with hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is extremely poor. The aim of this study was to elucidate the efficacy of hepatic arterial infusion chemotherapy (HAIC) for patients with advanced HCCs. METHODS: Forty-eight HCC patients with PVTT were treated by HAIC via a subcutaneously implanted injection port. Of these, 14 had PVTT in the second portal branch and 34 patients had PVTT in the first portal branch or in the main portal trunk. One course of chemotherapy consisted of daily cisplatin (7 mg/m(2) for 1 hour on Days 1-5) followed by 5-fluorouracil (170 mg/m(2) for 5 hours on Days 1-5). Patients were scheduled to receive four serial courses of HAIC. Responders were defined as having either a complete response (CR) or partial response (PR) and nonresponders were defined as exhibiting stable disease or progressive disease. The prognosis after HAIC and factors related to survival were analyzed. RESULTS: Following HAIC, 4 and 19 patients exhibited a CR and PR, respectively (response rate = 48%). The 1, 2, 3, and 5-year cumulative survival rates of 48 patients treated with HAIC were 45%, 31%, 25%, and 11%, respectively. Median survival periods for 23 responders and 25 nonresponders were 31.6 (range, 8.3-76.9) months and 5.4 (1.9-29.0) months, respectively. Therapeutic effect (P < 0.001) and hepatic reserve capacity (P = 0.021) were identified as significant prognostic factors by univariate analysis. Multivariate analysis identified only therapeutic effect as being significantly related to survival. CONCLUSIONS: HAIC using low-dose cisplatin and 5-fluorouracil may be a useful therapeutic option for patients with advanced HCC with PVTT. HCC patients with PVTT who respond to HAIC could certainly have survival benefits. Copyright 2002 American Cancer Society.

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以下是引用medline在2002-10-24 12:00:00的发言： Cancer 2002 Aug 1;95(3):588-95 Related Articles, Links      Hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma with portal vein tumor thrombosis: analysis of 48 cases. 对advanced(晚期?)肝癌并伴有门静脉癌栓的肝动脉注入疗法 Ando E, Tanaka M, Yamashita F, Kuromatsu R, Yutani S, Fukumori K, Sumie S, Yano Y, Okuda K, Sata M. Department of Medicine II, Kurume University School of Medicine, 67 Asahi-Machi, Kurume-shi, Fukuoka-ken 830-0011, Japan. [email protected] BACKGROUND: The prognosis of patients with hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is extremely poor. 背景：肝癌合并门静脉癌栓的患者的预后极其不好。The aim of this study was to elucidate the efficacy of hepatic arterial infusion chemotherapy (HAIC) for patients with advanced HCCs. 这个研究的目的是为了阐明对晚期肝癌患者的肝动脉注入疗法的效果。METHODS: Forty-eight HCC patients with VTT were treated by HAIC via a subcutaneously implanted injection port. 方法：对48个伴有门静脉癌栓的肝癌患者皮下植入注射点。Of these, 14 had VTT in the second portal branch and 34 patients had VTT in the first portal branch or in the main portal trunk. 其中，14个患者在门静脉的第二个分支上有癌栓，34个患者在第一个分枝上或者是门静脉主干上有癌栓One course of chemotherapy consisted of daily cisplatin (7 mg/m(2) for 1 hour on Days 1-5) followed by 5-fluorouracil (170 mg/m(2) for 5 hours on Days 1-5). 一个化学疗法的疗程包括每天 cisplatin(可能是一种药物)(第一到第五天 7mg/m(2) 用一个小时) 接着是5－fluorouracil(第一到第五天 170mg/m(2) 用5个小时)。Patients were scheduled to receive four serial courses of HAIC. 患者要连续接收4个疗程的治疗。Responders were defined as having either a complete response (CR) or partial response (PR) and nonresponders were defined as exhibiting stable disease or progressive disease.有应答者被定义为具有完全应答(CR) 或者部分应答(PR), 无应答者是指病情无变化或者仍在发展。 The prognosis after HAIC and factors related to survival were analyzed.分析了预后和那些和有利于幸存的因素 RESULTS: Following HAIC, 4 and 19 patients exhibited a CR and R, respectively (response rate = 48%). 结果：疗法疗程结束后，分别是4个和19个患者显示为完全应答和部分应答，（应答率48％）。The 1, 2, 3, and 5-year cumulative survival rates of 48 patients treated with HAIC were 45%, 31%, 25%, and 11%, respectively.1，2，3，5年的累进存活率分别是45％，31％，25％，和11％ 。Median survival periods for 23 responders and 25 nonresponders were 31.6 (range, 8.3-76.9) months and 5.4 (1.9-29.0) months, respectively.23个有应答者和25个无应答者的平均生存周期分别是31.6个月（从8.3-76.9个月）和5.4个月（从1.9-29.0个月）。 Therapeutic effect (P < 0.001) and hepatic reserve capacity (P = 0.021) were identified as significant prognostic factors by univariate analysis. 单变量分析，治疗效果(P<0.001)和患者肝脏自身的功能(p=0.021)是非常重要的预后因素。Multivariate analysis identified only therapeutic effect as being significantly related to survival. 多变量分析指出仅仅治疗效果对患者的生存有重大关系。CONCLUSIONS: HAIC using low-dose cisplatin and 5-fluorouracil may be a useful therapeutic option for patients with advanced HCC with VTT. 结论：肝动脉注入疗法对那些伴有门静脉癌栓的晚期肝癌患者也许是一个有用的治疗方案。HCC patients with VTT who respond to HAIC could certainly have survival benefits. 那些对这种疗法有应答的患者当然会获得生存方面的益处。Copyright 2002 American Cancer Society.