Hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma according to Child-Pugh classification

• Published in: Journal of gastroenterology and hepatology Vol. 27; no. 12; pp. 1850 - 1857
• Main Authors: Miyaki, Daisuke, Aikata, Hiroshi, Honda, Yohji, Naeshiro, Noriaki, Nakahara, Takashi, Tanaka, Mio, Nagaoki, Yuko, Kawaoka, Tomokazu, Takaki, Shintaro, Waki, Koji, Hiramatsu, Akira, Takahashi, Shoichi, Ishikawa, Masaki, Kakizawa, Hideaki, Awai, Kazuo, Chayama, Kazuaki
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01.12.2012
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Carcinoma, Hepatocellular - classification; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - mortality; Child-Pugh; Cisplatin - administration & dosage; Cohort Studies; Female; Fluorouracil - administration & dosage; Follow-Up Studies; hepatic arterial infusion chemotherapy; Hepatic Artery; hepatocellular carcinoma; Humans; Infusions, Intra-Arterial; Interferon-alpha - administration & dosage; Liver Neoplasms - classification; Liver Neoplasms - drug therapy; Liver Neoplasms - mortality; Male; Middle Aged; prognosis; Recombinant Proteins - administration & dosage; response; Retrospective Studies; Survival Rate; Treatment Outcome
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/j.1440-1746.2012.07276.x

Background and Aim We compared the treatment response, survival, and safety to hepatic arterial infusion chemotherapy (HAIC) in patients with advanced hepatocellular carcinoma (HCC) according to Child–Pugh (CP) score. Methods The study subjects were 249 patients with advanced HCC and CP class A and B who had been treated with HAIC. Patients were grouped according to CP score (5/6, 7 and 8/9) and their tumor response, tolerance, and survival were assessed. Results The median survival time (MST) was 8.2, 9.7, 6.3, and 3.9 months for the whole group, patients with CP 5/6, 7 and 8/9, respectively (P < 0.0001). Complete response (CR) and partial response (PR) were seen in 11 and 57 patients, respectively, with an overall response rate of 27.3%. The response rate was higher in patients with CP score 5/6 and 7, than CP 8/9 (30.5%, 28.2%, 13.8%). The dropout rate was significantly higher in patients with CP score 8/9 than the other two (8.0%, 12.8%, 33.3%, respectively). The survival rate was significantly better in patients who achieved CR/PR than the others with CP score 5/6, 7. CP score 8/9 was an independent negative factor for response and survival. Conclusion Advanced HCC patients with CP score of 5/6 and 7 showed a better response to HAIC and better prognosis than those with CP score 8/9.