Survival and Treatment Responses of Hepatic Arterial Infusion Chemotherapy for Advanced Hepatocellular Carcinoma

Abstract

Patients with advanced hepatocellular carcinoma (HCC) have a poor prognosis. Their median survival time was reported to be 2.7-4 months if they were left untreated. Hepatic arterial infusion chemotherapy (HAIC) has been regarded as one of the effective therapeutic modalities. So, the aim of this study was to evaluate survival and therapeutic responses of HAIC for advanced HCC. From January 2004 to November 2011, we retrospectively reviewed the data of patients with advanced HCC who received 2 sessions of HAIC or more. Tumor response thereto was measured by the abdominal CT scan at each session of HAIC using Modified Response Evaluation Criteria in Solid Tumors. 54 patients were enrolled. Their mean age was 57 year-old and 47 patients were male. 33 patients were under Child-Turcotte-Pugh Class A, 17 were under Class B, and 4 were under Class C. The causes of HCC were HBV (70.3%), HCV (11.1%), and alcoholics (13.0%). On average, patients received 4.2 sessions of HAIC. At the time of completing 2 sessions of HAIC, the median survival time of patients who achieved complete response (CR) or partial response (PR) (Group A) was 190 days, while that of patients who had stable disease (SD) or progressive disease (PD) (Group B) was 96 days (p=0.265). At the time of completing 4 sessions of HAIC, the median survival time of Group A and Group B was 302 days and 111 days, respectively (p=0.009). Advanced HCC without potal vein tumor thrombosis (PVTT) showed better therapeutic responses than advanced HCC with PVTT (p=0.021). HAIC can be a useful therapeutic modality for patients with advanced HCC. Presence of PVTT can be an independent predictive factor for therapeutic response of HAIC. However, prospective studies for identifying predictive factors of better prognosis of advanced HCC are still needed.