Transarterial infusion of epirubicin and cisplatin combined with systemic infusion of 5-fluorouracil transarterial chemoembolization using doxorubicin for unresectable hepatocellular carcinoma with portal vein tumor thrombosis: a retrospective analysis
Background: More than one-third of hepatocellular carcinoma (HCC) patients are diagnosed at advanced stage with portal vein tumor thrombosis (PVTT) or extrahepatic metastasis. However, the outcomes of current therapeutic approaches are unsatisfactory. As a novel therapeutic strategy for unresectable...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2017-10-01
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| Series: | Therapeutic Advances in Medical Oncology |
| Online Access: | https://doi.org/10.1177/1758834017728018 |
| _version_ | 1819106526934073344 |
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| author | Sung Won Lee Hae Lim Lee Nam Ik Han Jung Hyun Kwon Soon Woo Nam Jeong Won Jang Si Hyun Bae Jong Young Choi Seung Kew Yoon |
| author_facet | Sung Won Lee Hae Lim Lee Nam Ik Han Jung Hyun Kwon Soon Woo Nam Jeong Won Jang Si Hyun Bae Jong Young Choi Seung Kew Yoon |
| author_sort | Sung Won Lee |
| collection | DOAJ |
| description | Background: More than one-third of hepatocellular carcinoma (HCC) patients are diagnosed at advanced stage with portal vein tumor thrombosis (PVTT) or extrahepatic metastasis. However, the outcomes of current therapeutic approaches are unsatisfactory. As a novel therapeutic strategy for unresectable HCC with PVTT, we analyzed the outcomes of transarterial infusion of epirubicin and cisplatin combined with systemic infusion of 5-fluorouracil (TAC-ECF) and compared its therapeutic effects and toxicity with transarterial chemoembolization (TACE) using doxorubicin (DOX). Methods: A total of 540 consecutive HCC patients who received TACE at the Catholic Medical Center between January 2007 and November 2013 were enrolled. Of these patients, we retrospectively analyzed 129 Barcelona clinic liver cancer stage C HCC patients with PVTT who received either TAC-ECF or TACE using DOX. Results: The objective tumor response rate was higher in the TAC-ECF group, with 31.3% objective response rate after TAC-ECF compared to 10% after DOX treatment ( p = 0.004). Median follow-up period was 7 months (range, 1–57 months). The overall survival rate was also significantly higher in the TAC-ECF group compared to the DOX group (median 9.3 versus 4.6 months, p < 0.0001). Multivariate analysis revealed that TAC-ECF and extrahepatic metastasis were independent predictive factors for overall survival ( p < 0.0001 and p = 0.002 respectively). No serious adverse effects developed in both groups. Conclusions: TAC-ECF therapy was tolerable and showed higher overall survival rate and tumor response compared to the conventional TACE DOX in advanced stage HCC patients with PVTT. Therefore, TAC-ECF may be considered as an effective treatment option for patients with unresectable HCC. |
| first_indexed | 2024-12-22T02:39:33Z |
| format | Article |
| id | doaj.art-ec0436eb82d94776a259f0f84ca9a405 |
| institution | Directory Open Access Journal |
| issn | 1758-8340 1758-8359 |
| language | English |
| last_indexed | 2024-12-22T02:39:33Z |
| publishDate | 2017-10-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Medical Oncology |
| spelling | doaj.art-ec0436eb82d94776a259f0f84ca9a4052022-12-21T18:41:40ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83401758-83592017-10-01910.1177/1758834017728018Transarterial infusion of epirubicin and cisplatin combined with systemic infusion of 5-fluorouracil transarterial chemoembolization using doxorubicin for unresectable hepatocellular carcinoma with portal vein tumor thrombosis: a retrospective analysisSung Won LeeHae Lim LeeNam Ik HanJung Hyun KwonSoon Woo NamJeong Won JangSi Hyun BaeJong Young ChoiSeung Kew YoonBackground: More than one-third of hepatocellular carcinoma (HCC) patients are diagnosed at advanced stage with portal vein tumor thrombosis (PVTT) or extrahepatic metastasis. However, the outcomes of current therapeutic approaches are unsatisfactory. As a novel therapeutic strategy for unresectable HCC with PVTT, we analyzed the outcomes of transarterial infusion of epirubicin and cisplatin combined with systemic infusion of 5-fluorouracil (TAC-ECF) and compared its therapeutic effects and toxicity with transarterial chemoembolization (TACE) using doxorubicin (DOX). Methods: A total of 540 consecutive HCC patients who received TACE at the Catholic Medical Center between January 2007 and November 2013 were enrolled. Of these patients, we retrospectively analyzed 129 Barcelona clinic liver cancer stage C HCC patients with PVTT who received either TAC-ECF or TACE using DOX. Results: The objective tumor response rate was higher in the TAC-ECF group, with 31.3% objective response rate after TAC-ECF compared to 10% after DOX treatment ( p = 0.004). Median follow-up period was 7 months (range, 1–57 months). The overall survival rate was also significantly higher in the TAC-ECF group compared to the DOX group (median 9.3 versus 4.6 months, p < 0.0001). Multivariate analysis revealed that TAC-ECF and extrahepatic metastasis were independent predictive factors for overall survival ( p < 0.0001 and p = 0.002 respectively). No serious adverse effects developed in both groups. Conclusions: TAC-ECF therapy was tolerable and showed higher overall survival rate and tumor response compared to the conventional TACE DOX in advanced stage HCC patients with PVTT. Therefore, TAC-ECF may be considered as an effective treatment option for patients with unresectable HCC.https://doi.org/10.1177/1758834017728018 |
| spellingShingle | Sung Won Lee Hae Lim Lee Nam Ik Han Jung Hyun Kwon Soon Woo Nam Jeong Won Jang Si Hyun Bae Jong Young Choi Seung Kew Yoon Transarterial infusion of epirubicin and cisplatin combined with systemic infusion of 5-fluorouracil transarterial chemoembolization using doxorubicin for unresectable hepatocellular carcinoma with portal vein tumor thrombosis: a retrospective analysis Therapeutic Advances in Medical Oncology |
| title | Transarterial infusion of epirubicin and cisplatin combined with systemic infusion of 5-fluorouracil transarterial chemoembolization using doxorubicin for unresectable hepatocellular carcinoma with portal vein tumor thrombosis: a retrospective analysis |
| title_full | Transarterial infusion of epirubicin and cisplatin combined with systemic infusion of 5-fluorouracil transarterial chemoembolization using doxorubicin for unresectable hepatocellular carcinoma with portal vein tumor thrombosis: a retrospective analysis |
| title_fullStr | Transarterial infusion of epirubicin and cisplatin combined with systemic infusion of 5-fluorouracil transarterial chemoembolization using doxorubicin for unresectable hepatocellular carcinoma with portal vein tumor thrombosis: a retrospective analysis |
| title_full_unstemmed | Transarterial infusion of epirubicin and cisplatin combined with systemic infusion of 5-fluorouracil transarterial chemoembolization using doxorubicin for unresectable hepatocellular carcinoma with portal vein tumor thrombosis: a retrospective analysis |
| title_short | Transarterial infusion of epirubicin and cisplatin combined with systemic infusion of 5-fluorouracil transarterial chemoembolization using doxorubicin for unresectable hepatocellular carcinoma with portal vein tumor thrombosis: a retrospective analysis |
| title_sort | transarterial infusion of epirubicin and cisplatin combined with systemic infusion of 5 fluorouracil transarterial chemoembolization using doxorubicin for unresectable hepatocellular carcinoma with portal vein tumor thrombosis a retrospective analysis |
| url | https://doi.org/10.1177/1758834017728018 |
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