New Regimen of Combining Hepatic Arterial Infusion Chemotherapy and Lipiodol Embolization in Treating Hepatocellular Carcinoma with Main Portal Vein Invasion
Background: The prognosis of HCC patients with main portal vein invasion (Vp4) is poor. We retrospectively reviewed the therapeutic outcomes with our new HAIC regimen in treating Vp4 HCC patients. Patients and Methods: Seventy-one patients received the new regimen of combining HAIC (daily infusion o...
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| Format: | Article |
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MDPI AG
2022-12-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/13/1/88 |
| _version_ | 1797440056057659392 |
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| author | Ming-Feng Li Huei-Lung Liang Chia-Ling Chiang Wei-Lun Tsai Wen-Chi Chen Cheng-Chung Tsai I-Shu Chen |
| author_facet | Ming-Feng Li Huei-Lung Liang Chia-Ling Chiang Wei-Lun Tsai Wen-Chi Chen Cheng-Chung Tsai I-Shu Chen |
| author_sort | Ming-Feng Li |
| collection | DOAJ |
| description | Background: The prognosis of HCC patients with main portal vein invasion (Vp4) is poor. We retrospectively reviewed the therapeutic outcomes with our new HAIC regimen in treating Vp4 HCC patients. Patients and Methods: Seventy-one patients received the new regimen of combining HAIC (daily infusion of cisplatin (10 mg/m<sup>2</sup>), mitomycin-C (2 mg/m<sup>2</sup>) and Leucovorin (15 mg/m<sup>2</sup>) plus 100 mg/m<sup>2</sup> of 5-fluorouracil (5-FU) using an infusion pump for 5 consecutive days) with Lipiodol embolization between 2002 and 2018. Twenty-two patients (31.0%) also received sorafenib. The Kaplan–Meier curve was used to calculate progression-free survival (PFS) and overall survival (OS). The OS of patients with or without additional sorafenib use or extrahepatic spread (EHS) was also compared. Results: Fifty-six patients (78.9%) had Child-Pugh A liver function. The mean maximal tumor size was 10.3 cm. Twenty patients (28.2%) had EHS at their initial diagnosis. The objective response rate according to the Modified Response Evaluation Criteria in Solid Tumors (mRECIST) and median OS were 64.8% and 13 months. The 1-, 2- and 3-year survival rates were 53.1%, 21.5% and 18.7%, respectively. In the subgroup analysis, there were no significant survival difference between patients with HAIC only vs. HAIC plus sorafenib (14 vs. 13 months) and between patients with vs. without EHS (12 vs. 13 months). Conclusions: Our new HAIC regimen is effective in treating Vp4 HCC patients. Additional sorafenib use with our new HAIC regimen provided no survival benefit. |
| first_indexed | 2024-03-09T12:02:38Z |
| format | Article |
| id | doaj.art-4fb2681112c240aabb34f42e8aa916a8 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-09T12:02:38Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-4fb2681112c240aabb34f42e8aa916a82023-11-30T23:01:58ZengMDPI AGJournal of Personalized Medicine2075-44262022-12-011318810.3390/jpm13010088New Regimen of Combining Hepatic Arterial Infusion Chemotherapy and Lipiodol Embolization in Treating Hepatocellular Carcinoma with Main Portal Vein InvasionMing-Feng Li0Huei-Lung Liang1Chia-Ling Chiang2Wei-Lun Tsai3Wen-Chi Chen4Cheng-Chung Tsai5I-Shu Chen6Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung 813414, TaiwanDepartment of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung 813414, TaiwanDepartment of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung 813414, TaiwanDepartment of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821004, TaiwanDivision of Gastroenterology and Hepatology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813414, TaiwanDepartment of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 813414, TaiwanDepartment of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 813414, TaiwanBackground: The prognosis of HCC patients with main portal vein invasion (Vp4) is poor. We retrospectively reviewed the therapeutic outcomes with our new HAIC regimen in treating Vp4 HCC patients. Patients and Methods: Seventy-one patients received the new regimen of combining HAIC (daily infusion of cisplatin (10 mg/m<sup>2</sup>), mitomycin-C (2 mg/m<sup>2</sup>) and Leucovorin (15 mg/m<sup>2</sup>) plus 100 mg/m<sup>2</sup> of 5-fluorouracil (5-FU) using an infusion pump for 5 consecutive days) with Lipiodol embolization between 2002 and 2018. Twenty-two patients (31.0%) also received sorafenib. The Kaplan–Meier curve was used to calculate progression-free survival (PFS) and overall survival (OS). The OS of patients with or without additional sorafenib use or extrahepatic spread (EHS) was also compared. Results: Fifty-six patients (78.9%) had Child-Pugh A liver function. The mean maximal tumor size was 10.3 cm. Twenty patients (28.2%) had EHS at their initial diagnosis. The objective response rate according to the Modified Response Evaluation Criteria in Solid Tumors (mRECIST) and median OS were 64.8% and 13 months. The 1-, 2- and 3-year survival rates were 53.1%, 21.5% and 18.7%, respectively. In the subgroup analysis, there were no significant survival difference between patients with HAIC only vs. HAIC plus sorafenib (14 vs. 13 months) and between patients with vs. without EHS (12 vs. 13 months). Conclusions: Our new HAIC regimen is effective in treating Vp4 HCC patients. Additional sorafenib use with our new HAIC regimen provided no survival benefit.https://www.mdpi.com/2075-4426/13/1/88hepatocellular carcinomahepatic arterial infusion chemotherapylipiodol embolizationmain portal vein invasion |
| spellingShingle | Ming-Feng Li Huei-Lung Liang Chia-Ling Chiang Wei-Lun Tsai Wen-Chi Chen Cheng-Chung Tsai I-Shu Chen New Regimen of Combining Hepatic Arterial Infusion Chemotherapy and Lipiodol Embolization in Treating Hepatocellular Carcinoma with Main Portal Vein Invasion Journal of Personalized Medicine hepatocellular carcinoma hepatic arterial infusion chemotherapy lipiodol embolization main portal vein invasion |
| title | New Regimen of Combining Hepatic Arterial Infusion Chemotherapy and Lipiodol Embolization in Treating Hepatocellular Carcinoma with Main Portal Vein Invasion |
| title_full | New Regimen of Combining Hepatic Arterial Infusion Chemotherapy and Lipiodol Embolization in Treating Hepatocellular Carcinoma with Main Portal Vein Invasion |
| title_fullStr | New Regimen of Combining Hepatic Arterial Infusion Chemotherapy and Lipiodol Embolization in Treating Hepatocellular Carcinoma with Main Portal Vein Invasion |
| title_full_unstemmed | New Regimen of Combining Hepatic Arterial Infusion Chemotherapy and Lipiodol Embolization in Treating Hepatocellular Carcinoma with Main Portal Vein Invasion |
| title_short | New Regimen of Combining Hepatic Arterial Infusion Chemotherapy and Lipiodol Embolization in Treating Hepatocellular Carcinoma with Main Portal Vein Invasion |
| title_sort | new regimen of combining hepatic arterial infusion chemotherapy and lipiodol embolization in treating hepatocellular carcinoma with main portal vein invasion |
| topic | hepatocellular carcinoma hepatic arterial infusion chemotherapy lipiodol embolization main portal vein invasion |
| url | https://www.mdpi.com/2075-4426/13/1/88 |
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