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A randomized comparative study of high-dose and low-dose hepatic arterial infusion chemotherapy for intractable, advanced hepatocellular carcinoma

Authors
 Hyun Young Woo  ;  Si Hyun Bae  ;  Jun Yong Park  ;  Kwang Hyub Han  ;  Ho Jong Chun  ;  Byung Gil Choi  ;  Hyeon U. Im  ;  Jong Young Choi  ;  Seung Kew Yoon  ;  Jae Youn Cheong  ;  Sung Won Cho  ;  Byoung Kuk Jang  ;  Jae Seok Hwang  ;  Sang Gyune Kim  ;  Young Seok Kim  ;  Yeon Seok Seo  ;  Hyung Joon Yim  ;  Soon Ho Um 
Citation
 CANCER CHEMOTHERAPY AND PHARMACOLOGY, Vol.65(2) : 373-382, 2010 
Journal Title
CANCER CHEMOTHERAPY AND PHARMACOLOGY
ISSN
 0344-5704 
Issue Date
2010
MeSH
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Carcinoma, Hepatocellular/drug therapy* ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/pathology ; Cisplatin/administration & dosage ; Drug Administration Schedule ; Female ; Fluorouracil/administration & dosage ; Hepatic Artery ; Humans ; Infusions, Intra-Arterial ; Liver Neoplasms/drug therapy* ; Liver Neoplasms/mortality ; Liver Neoplasms/pathology ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; Survival Rate
Keywords
Hepatocellular carcinoma ; Hepatic arterial infusion chemotherapy ; High dose ; Low dose 5-Fluorouracil Cisplatin
Abstract
PURPOSE: Hepatic arterial infusion chemotherapy (HAIC) has been reported to be effective in patients with advanced hepatocellular carcinoma (HCC).

METHODS: In this multicenter, prospective, open-labeled, clinical trial, we randomly assigned 68 patients with advanced HCC to receive either low-dose [n = 32, 5-fluorouracil (FU), 170 mg/m(2) and cisplatin, 7 mg/m(2) on days 1-5] or high-dose HAIC (n = 36, 5-FU, 500 mg/m(2) on days 1-3 and cisplatin, 60 mg/m(2) on day 2) every 4 weeks via an implantable port system.

RESULTS: A total of 207 cycles of HAIC was given to the 68 patients. Overall, 6 patients (8.8%) achieved a partial response and 21 patients (30.9%) had stable disease. The objective response rate (CR + PR) was significantly improved in the high-dose group compared to the low-dose group (16.7% vs. 0%, P = 0.024). The median time to disease progression and overall survival were slightly prolonged in the high-dose group compared to the low-dose group (median survival, 193 vs. 153 days; P = 0.108; median time to disease progression, 145 vs. 90 days; P = 0.095). Multivariate analysis showed that tumor response to treatment [P = 0.007, RR 2.27 (95% CI, 1.248-4.132)] was the only factor associated with overall survival. All adverse events were tolerable and successfully managed in both treatment groups.

CONCLUSIONS: Both HAIC regimens are safe and effective in patients with advanced HCC. High-dose HAIC achieves a better tumor response compared to low-dose HAIC.
Full Text
http://link.springer.com/article/10.1007%2Fs00280-009-1126-2
DOI
10.1007/s00280-009-1126-2
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/101938
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