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High-dose versus Low-dose 5-Fluorouracil and Cisplatin Based Hepatic Arterial Infusion Chemotherapy for Advanced Hepatocellular Carcinoma

대한간암학회지 2019년 19권 1호 p.38 ~ 45
임채준, 홍지연, Ko Yang-Seok, Chung Min-Woo, Jun Chung-Hwan, 최성규, 조성범,
소속 상세정보
임채준 ( Lim Chae-June ) - Chonnam National University Medical School Department of Internal Medicine
홍지연 ( Hong Ji-Yun ) - Chonnam National University Medical School Department of Internal Medicine
 ( Ko Yang-Seok ) - Chonnam National University Medical School Department of General Surgery
 ( Chung Min-Woo ) - Chonnam National University Medical School Department of Internal Medicine
 ( Jun Chung-Hwan ) - Chonnam National University Medical School Department of Internal Medicine
최성규 ( Choi Sung-Kyu ) - Chonnam National University Medical School Department of Internal Medicine
조성범 ( Cho Sung-Bum ) - Chonnam National University Medical School Department of Internal Medicine

Abstract


Backgrounds/Aims: Hepatic arterial infusion chemotherapy (HAIC) has been reported as an effective treatment for advanced hepatocellular carcinoma. The aim of this study is to compare the effect and safety between a high-dose regimen (750 mg/m2 5-fluorouracil [FU] and 25 mg/m2 cisplatin on day 1-4) and a low-dose regimen (500 mg/m2 5-FU on day 1-3 with 60 mg/m2 cisplatin on day 2).

Methods: A total of 48 patients undergoing HAIC were retrospectively analyzed. Thirty-two patients were treated with the high-dose and 16 patients with the low-dose regimen.

Results: Complete response (CR), partial response (PR), stable disease (SD), and progressive disease were noted in one (3.1%), 15 (46.9%), three (9.4%), and 13 patients (40.6%) in the highdose group, and 0 (0%), one (6.3%), eight (50%), and seven patients (43.8%) in the low-dose group (p=0.002). The disease control rate (CR, PR, and SD) did not differ between groups (59.4% vs. 56.3%, p=1.000), but the objective response rate (CR and PR) was significantly higher in the high-dose group (50.0% vs. 6.3%, p=0.003). The median progression free survival did not differ between groups (4.0 vs. 6.0, p=0.734), but overall survival was significantly longer in the high-dose group (not reached vs. 16.0, p=0.028). Fourteen (43.8%) patients in the highdose group and two patients (12.5%) in the low-dose group experienced grade 3-4 toxicities (p=0.050).

Conclusions: High dose HAIC may achieve better tumor response and may improve overall survival compared to a low-dose regimen. However, the high-dose regimen should be administered cautiously because of the higher incidence of adverse events.

키워드

Hepatocellular carcinoma; Chemotherapy, cancer, regional perfusion; Administration, metronomic

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