Efficacy and safety of chemoradiation therapy using one-shot cisplatin via hepatic arterial infusion for advanced hepatocellular carcinoma with major macrovascular invasion: a single-arm retrospective cohort study

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)...

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Main Authors: Kensuke Naruto, Tomokazu Kawaoka, Kenichiro Kodama, Yutaro Ogawa, Kei Amioka, Yuki Yoshikawa, Chihiro Kikukawa, Yousuke Suehiro, Kenji Yamaoka, Yuwa Ando, Yumi Kosaka, Shinsuke Uchikawa, Takashi Nakahara, Eisuke Murakami, Atsushi Ono, Takuro Uchida, Masami Yamauchi, Wataru Okamoto, Shoichi Takahashi, Michio Imamura, Keigo Chosa, Kazuo Awai, Katsumaro Kubo, Yasushi Nagata, Kazuaki Chayama, Hiroshi Aikata
Format: Article
Language:English
Published: BMC 2022-06-01
Series:BMC Gastroenterology
Subjects:
Online Access:https://doi.org/10.1186/s12876-022-02359-x
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author Kensuke Naruto
Tomokazu Kawaoka
Kenichiro Kodama
Yutaro Ogawa
Kei Amioka
Yuki Yoshikawa
Chihiro Kikukawa
Yousuke Suehiro
Kenji Yamaoka
Yuwa Ando
Yumi Kosaka
Shinsuke Uchikawa
Takashi Nakahara
Eisuke Murakami
Atsushi Ono
Takuro Uchida
Masami Yamauchi
Wataru Okamoto
Shoichi Takahashi
Michio Imamura
Keigo Chosa
Kazuo Awai
Katsumaro Kubo
Yasushi Nagata
Kazuaki Chayama
Hiroshi Aikata
author_facet Kensuke Naruto
Tomokazu Kawaoka
Kenichiro Kodama
Yutaro Ogawa
Kei Amioka
Yuki Yoshikawa
Chihiro Kikukawa
Yousuke Suehiro
Kenji Yamaoka
Yuwa Ando
Yumi Kosaka
Shinsuke Uchikawa
Takashi Nakahara
Eisuke Murakami
Atsushi Ono
Takuro Uchida
Masami Yamauchi
Wataru Okamoto
Shoichi Takahashi
Michio Imamura
Keigo Chosa
Kazuo Awai
Katsumaro Kubo
Yasushi Nagata
Kazuaki Chayama
Hiroshi Aikata
author_sort Kensuke Naruto
collection DOAJ
description 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.
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spelling doaj.art-93a7ea8c43054f84af8a2d302d0c6ab02022-12-22T00:29:02ZengBMCBMC Gastroenterology1471-230X2022-06-0122111010.1186/s12876-022-02359-xEfficacy and safety of chemoradiation therapy using one-shot cisplatin via hepatic arterial infusion for advanced hepatocellular carcinoma with major macrovascular invasion: a single-arm retrospective cohort studyKensuke Naruto0Tomokazu Kawaoka1Kenichiro Kodama2Yutaro Ogawa3Kei Amioka4Yuki Yoshikawa5Chihiro Kikukawa6Yousuke Suehiro7Kenji Yamaoka8Yuwa Ando9Yumi Kosaka10Shinsuke Uchikawa11Takashi Nakahara12Eisuke Murakami13Atsushi Ono14Takuro Uchida15Masami Yamauchi16Wataru Okamoto17Shoichi Takahashi18Michio Imamura19Keigo Chosa20Kazuo Awai21Katsumaro Kubo22Yasushi Nagata23Kazuaki Chayama24Hiroshi Aikata25Department of Gastroenterology and Metabolism, Hiroshima UniversityDepartment of Gastroenterology and Metabolism, Hiroshima UniversityDepartment of Gastroenterology and Metabolism, Hiroshima UniversityDepartment of Gastroenterology and Metabolism, Hiroshima UniversityDepartment of Gastroenterology and Metabolism, Hiroshima UniversityDepartment of Gastroenterology and Metabolism, Hiroshima UniversityDepartment of Gastroenterology and Metabolism, Hiroshima UniversityDepartment of Gastroenterology and Metabolism, Hiroshima UniversityDepartment of Gastroenterology and Metabolism, Hiroshima UniversityDepartment of Gastroenterology and Metabolism, Hiroshima UniversityDepartment of Gastroenterology and Metabolism, Hiroshima UniversityDepartment of Gastroenterology and Metabolism, Hiroshima UniversityDepartment of Gastroenterology and Metabolism, Hiroshima UniversityDepartment of Gastroenterology and Metabolism, Hiroshima UniversityDepartment of Gastroenterology and Metabolism, Hiroshima UniversityDepartment of Gastroenterology and Metabolism, Hiroshima UniversityDepartment of Gastroenterology and Metabolism, Hiroshima UniversityDepartment of Gastroenterology and Metabolism, Hiroshima UniversityDepartment of Gastroenterology and Metabolism, Hiroshima UniversityDepartment of Gastroenterology and Metabolism, Hiroshima UniversityDiagnostic Radiology, Hiroshima UniversityDiagnostic Radiology, Hiroshima UniversityTherapeutic Radiology, Institute and Graduate School of Biomedical Sciences, Hiroshima UniversityTherapeutic Radiology, Institute and Graduate School of Biomedical Sciences, Hiroshima UniversityResearch Center for Hepatology and Gastroenterology, Hiroshima UniversityDepartment of Gastroenterology and Metabolism, Hiroshima UniversityAbstract 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.https://doi.org/10.1186/s12876-022-02359-xHepatocellular carcinomaMacrovascular invasionHepatic arterial infusion chemotherapyRadiation therapy
spellingShingle Kensuke Naruto
Tomokazu Kawaoka
Kenichiro Kodama
Yutaro Ogawa
Kei Amioka
Yuki Yoshikawa
Chihiro Kikukawa
Yousuke Suehiro
Kenji Yamaoka
Yuwa Ando
Yumi Kosaka
Shinsuke Uchikawa
Takashi Nakahara
Eisuke Murakami
Atsushi Ono
Takuro Uchida
Masami Yamauchi
Wataru Okamoto
Shoichi Takahashi
Michio Imamura
Keigo Chosa
Kazuo Awai
Katsumaro Kubo
Yasushi Nagata
Kazuaki Chayama
Hiroshi Aikata
Efficacy and safety of chemoradiation therapy using one-shot cisplatin via hepatic arterial infusion for advanced hepatocellular carcinoma with major macrovascular invasion: a single-arm retrospective cohort study
BMC Gastroenterology
Hepatocellular carcinoma
Macrovascular invasion
Hepatic arterial infusion chemotherapy
Radiation therapy
title Efficacy and safety of chemoradiation therapy using one-shot cisplatin via hepatic arterial infusion for advanced hepatocellular carcinoma with major macrovascular invasion: a single-arm retrospective cohort study
title_full Efficacy and safety of chemoradiation therapy using one-shot cisplatin via hepatic arterial infusion for advanced hepatocellular carcinoma with major macrovascular invasion: a single-arm retrospective cohort study
title_fullStr Efficacy and safety of chemoradiation therapy using one-shot cisplatin via hepatic arterial infusion for advanced hepatocellular carcinoma with major macrovascular invasion: a single-arm retrospective cohort study
title_full_unstemmed Efficacy and safety of chemoradiation therapy using one-shot cisplatin via hepatic arterial infusion for advanced hepatocellular carcinoma with major macrovascular invasion: a single-arm retrospective cohort study
title_short Efficacy and safety of chemoradiation therapy using one-shot cisplatin via hepatic arterial infusion for advanced hepatocellular carcinoma with major macrovascular invasion: a single-arm retrospective cohort study
title_sort efficacy and safety of chemoradiation therapy using one shot cisplatin via hepatic arterial infusion for advanced hepatocellular carcinoma with major macrovascular invasion a single arm retrospective cohort study
topic Hepatocellular carcinoma
Macrovascular invasion
Hepatic arterial infusion chemotherapy
Radiation therapy
url https://doi.org/10.1186/s12876-022-02359-x
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