Retrospective Study
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 21, 2014; 20(31): 10960-10968
Published online Aug 21, 2014. doi: 10.3748/wjg.v20.i31.10960
Chemotherapy for transarterial chemoembolization in patients with unresectable hepatocellular carcinoma
Jie Wu, Lei Song, Dan-Yi Zhao, Bing Guo, Jing Liu
Jie Wu, Lei Song, Dan-Yi Zhao, Bing Guo, Jing Liu, Department of Medical Oncology, the Second Hospital of Dalian Medical University, Dalian 116023, Liaoning Province, China
Author contributions: Wu J conducted the extensive literature search and wrote the manuscript; Song L designed the study; Zhao DY read and revised the text with the addition of references; Guo B and Liu J collected the clinical data and follow-up of all the patients.
Correspondence to: Lei Song, MS, Department of Medical Oncology, the Second Hospital of Dalian Medical University, Zhongshan Road 467, Dalian 116023, Liaoning Province, China. songlei_1975@126.com
Telephone: +86-21-64085875 Fax: +86-21-64085875
Received: February 20, 2014
Revised: April 7, 2014
Accepted: May 19, 2014
Published online: August 21, 2014
Abstract

AIM: To compare the efficacy of different chemotherapeutic agents during conventional transarterial chemoembolization (cTACE) in the treatment of unresectable hepatocellular carcinoma (HCC).

METHODS: A retrospective review was undertaken of patients with unresectable HCC undergoing cTACE from May 2003 to November 2011. A total of 107 patients were treated with at least one cTACE session. Irinotecan (CPT-11) was used as a chemotherapeutic agent in 24 patients, gemcitabine (GEM) in 24 and doxorubicin in 59.

RESULTS: The time to progression and overall survival rates were significantly superior in patients treated with CPT-11 compared with the GEM or doxorubicin treated groups (11.4, 8.2, 9.5 mo, P = 0.02 and 21.7, 12.7, 14.5 mo, P = 0.004, respectively). Subgroup analysis showed that for intermediate-stage HCC, CPT-11 resulted in a significantly longer time to progression and overall survival compared with the GEM or doxorubicin treated groups (P = 0.022; P = 0.003, respectively). There were no significant differences in adverse events among the three groups (P > 0.05).

CONCLUSION: For patients treated with cTACE, the chemotherapeutic agent CPT-11 was significantly associated with improved overall survival and delayed tumor progression compared with GEM or doxorubicin. There were no significant differences in clinical adverse events between the three agents. CPT-11 thus appears to be a promising agent when combined with cTACE for the treatment of HCC.

Keywords: Irinotecan, Gemcitabine, Transarterial chemoembolization, Hepatocellular carcinoma, Overall survival

Core tip: In the present study, we aimed to compare the efficacy of different chemotherapeutic agents during conventional transarterial chemoembolization (cTACE) in the treatment of unresectable hepatocellular carcinoma. Our study indicated that for patients treated with cTACE, the chemotherapeutic agent irinotecan (CPT-11) was significantly associated with improved overall survival and longer time to progression compared with gemcitabine or doxorubicin. There were no significant differences in clinical adverse events between the three agents. CPT-11 thus appears to be a promising agent when combined with cTACE for the treatment of hepatocellular carcinoma.