Retrospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 21, 2018; 24(23): 2501-2507
Published online Jun 21, 2018. doi: 10.3748/wjg.v24.i23.2501
Transarterial embolization and low-dose continuous hepatic arterial infusion chemotherapy with oxaliplatin and raltitrexed for hepatocellular carcinoma with major portal vein tumor thrombus
Lin-Zhong Zhu, Song Xu, Hai-Long Qian
Lin-Zhong Zhu, Department of Interventional Therapy, Beijing Cancer Hospital, Beijing 100142, China
Song Xu, Department of Radiology, Yunnan Second People’s Hospital, Kunming 650021, Yunnan Province, China
Hai-Long Qian, Interventional Therapy, Baotou Cancer Hospital, Baotou 014030, Inner Mongolia, China
Author contributions: Zhu LZ and Qian HL designed and performed this study; Zhu LZ analyzed the data; Xu S wrote the paper; Zhu LZ revised the manuscript for final submission.
Supported by the National Key R and D Program of China, No. 2016YFC0106604; and the National Natural Science Foundation of China, No. 81502591.
Institutional review board statement: The study was reviewed and approved by the Peking University Cancer Hospital’s Institutional Review Board.
Institutional animal care and use committee statement: The pharmacokinetics study was reviewed and approved by the Department of Laboratory Animal Science, Peking University Health Science Center.
Conflict-of-interest statement: The authors declare, to the best of our knowledge, no conflict of interest exists.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hai-Long Qian, MD, Doctor, Department of Interventional Therapy, Baotou Cancer Hospital, 18 Tuanjie Street, Qingshan District, Baotou 014030, Inner Mongolia, China. hailongqian@163.com
Telephone: +86-472-5156644
Received: February 7, 2018
Peer-review started: February 7, 2018
First decision: February 24, 2018
Revised: March 9, 2018
Accepted: March 25, 2018
Article in press: March 25, 2018
Published online: June 21, 2018
Abstract
AIM

To determine the efficacy and safety of transarterial embolization and low-dose continuous hepatic arterial infusion chemotherapy with oxaliplatin and raltitrexed in hepatocellular carcinoma (HCC) with major portal vein tumor thrombus (MPVTT).

METHODS

Eighty-six patients with MPVTT accepted routine embolization. The catheter was kept in the hepatic artery and oxaliplatin (50 mg in 250 mL of glucose) was infused by pump for 4 h, followed by raltitrexed (2 mg in 100 mL of 0.9% saline) infusion by pump for the next 1 h. The efficacy and safety were evaluated after the transarterial chemoembolization (TACE).

RESULTS

Full or partial embolization was achieved in 86 cases, where all the cases received low dose continuous hepatic arterial infusion chemotherapy. Complete responses (CRs), partial responses (PRs), stable disease (SD), and disease progression (PD) for intrahepatic disease were observed in 0, 45, 20, and 21 patients, respectively. The 1-, 2-and 3-year overall survival rates of the 86 patients were 40.7%, 22.1%, and 8.1% respectively, and the median survival time was 8.7 mo. Complication was limited.

CONCLUSION

TACE with low dose continuous hepatic arterial infusion of oxaliplatin and raltitrexed could be an option in MPVTT patient; it was shown to be effective in patients with advanced HCC with MPVTT with less toxicity.

Keywords: Transarterial embolization, Oxaliplatin, Major portal vein tumor thrombus, Raltitrexed, Continuous hepatic arterial infusion chemotherapy

Core tip: We analyzed the pharmacokinetic and pharmacodynamic characteristics of continuous hepatic arterial infusion of oxaliplatin and raltitrexed to aid interventional radiologist in determining a more accurate infusion protocol. The clinical protocol based on the pharmacokinetics study in a swine model and the pharmacodynamics study in tumor cell lines was shown to be effective and safe in hepatocellular carcinoma with main portal vein tumor thrombus.