Prevention of intrahepatic distant recurrence by transcatheter arterial infusion chemotherapy with platinum agents for stage I/II hepatocellular carcinoma

Cancer. 2011 Sep 1;117(17):4018-25. doi: 10.1002/cncr.25989. Epub 2011 Mar 1.

Abstract

Background: The effectiveness of additional chemotherapy in preventing intrahepatic distant tumor recurrence of hepatocellular carcinoma (HCC) has not been fully established. The authors compared the efficacy of 2 platinum-based chemotherapeutic agents in combination with radical local treatment for preventing intrahepatic distant recurrence (IDR).

Methods: Seventy-eight patients with stage I/II HCC aged 45 to 85 years underwent transcatheter arterial chemoembolization and/or radiofrequency ablation after they received hepatic arterial infusion (HAI) of platinum compounds. The HAI consisted of cis-diammine(1,1-cyclobutanedicarboxylato)platinum(II) (carboplatin) in 25 patients and cis-diamminedichloroplatinum (II) (cisplatin) in 53 patients. Multivariate analysis was used to identify independent factors that were associated with IDR.

Results: Cumulative IDR rates at 1 year, 2 years, and 3 years were 21.7%, 52.2% and 75.7%, respectively, in the carboplatin group and 8.1%, 22.7%, and 36.9%, respectively, in the cisplatin group. The cisplatin group had a significantly lower IDR rate compared with the carboplatin group. The selection of a platinum agent was 1 of the independent factors for IDR in a multivariate Cox proportional hazards model.

Conclusions: HAI chemotherapy with cisplatin before radical local treatment was effective in patients with HCC. The authors concluded that radical local treatment with concurrent HAI using cisplatin may contribute to a longer progression-free period, which could be predicted with intrahepatic imaging in patients with stage I/II HCC.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Aged
  • Carboplatin / administration & dosage*
  • Carboplatin / adverse effects
  • Carcinoma, Hepatocellular / drug therapy
  • Carcinoma, Hepatocellular / pathology
  • Cisplatin / administration & dosage*
  • Cisplatin / adverse effects
  • Disease-Free Survival
  • Female
  • Humans
  • Infusions, Intra-Arterial / methods*
  • Liver Neoplasms / drug therapy
  • Liver Neoplasms / pathology
  • Male
  • Middle Aged
  • Neoplasm Metastasis / prevention & control*
  • Neoplasm Recurrence, Local / prevention & control

Substances

  • Carboplatin
  • Cisplatin