Background: Transcatheter arterial chemoembolization (TACE) was performed as the initial therapy for advanced hepatocellular carcinoma (HCC). However, no effective chemotherapy has been established for patients who did not respond to TACE, and for those the therapy was not suitable. Since 2004, transcatheter arterial infusion (TAI) chemotherapy using fine-powder cisplatin has been applied at our department to such cases mentioned before. This report described the therapeutic results of TAI therapy and presented a case of HCC accompanied by portal vein tumor thrombus (PVTT) for which the therapy was effective.
Patients and methods: TAI was performed using cisplatin in 16 patients with inoperable advanced HCC between 2004 and 2010. Cisplatin was infused into the proper hepatic artery at a dose of 65 mg/m2 for 30 minutes.
Results: TAI was performed in each patient 1.8 times on average, ranging from 1 to 8 times. Therapeutic Effect 4 (TE4) was obtained in 1 case, TE3 in 2, TE2 in 1, and TE1 in 11 cases. The only severe adverse event rated as grade 3 or above during the study were nausea and anorexia reported in 6.3% of the patients, and adverse events rated as less than grade 2 were increased serum hepato-biliary enzyme levels in 68.8%, nausea in 68.8% of the patients. The overall 1-year survival rate was 31.2%, and the 50% survival period was 314 days.
Conclusion: As a treatment option following the initial TACE therapy for advanced HCC, TAI using cisplatin can improve the prognosis of HCC.