Published online Jun 21, 2018. doi: 10.3748/wjg.v24.i23.2501
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
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).
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).
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.
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.
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.