Chemotherapy for transarterial chemoembolization in patients with unresectable hepatocellular carcinoma

Table 1 Baseline characteristics

	Total	CPT-11	GEM	DDP+5-FU	P value
	(n = 107)	(n = 24)	(n = 24)	(n = 59)	OS	PFS
Mean age ± SD (yr)	57.0 ± 11.0	61.0 ± 8.7	57.5 ± 12.4	56.0 ± 11.4
Sex (M:F)	95:12	22:2	24:0	49:10
HBV
Absent/Present	26/81	7/17	6/18	13/46	0.583	0.734
Cirrhosis of the liver
Absent/Present	45/62	13/11	6/18	26/33	0.003	0.011
Tumor maximal diameter (cm)	7.8 ± 4.1	8.0 ± 3.9	7.7 ± 4.1	7.4 ± 4.2
≤ 5/> 5	30/77	4/20	5/19	21/38	0.361	0.165
Pathological T
T1/T2/T3/T4	8/32/50/17	3/8/10/3	0/9/10/5	5/15/30/9	0.070	0.052
Pathological Stage
I/II/III/IV	7/26/57/17	3/6/10/5	0/6/13/5	4/14/34/7	0.013	0.022
TACE Sessions
≤ 2/> 2	73/34	8/16	18/6	47/12	0.001	0.009
Initial AFP (ng/dL)
≤ 400/> 400	59/48	18/6	11/13	16/43	0.095	0.157
Number of Tumor Single/Multiple	57/50	12/12	13/11	32/27	0.017	0.039
Vascular invasion
Absent/Present	74/33	18/6	15/9	41/18	0.014	0.090
Child-Pugh
A/B	98/9	20/4	23/1	55/4	0.746	0.930
BCLC Stage
A/B/C	15/59/33	2/16/6	1/14/9	12/29/18	0.005	0.006
CLIP Score
≤ 2/> 2	77/20	20/4	18/6	39/20	0.013	0.013
MELD Score
≤ 6/> 6	74/33	17/7	16/8	41/18	0.914	0.610
ALB (g/L)
≤ 40/> 40	49/58	9/15	7/17	33/26	0.033	0.073
TB (μmol/L)
≤ 17/> 17	55/52	14/10	12/12	29/30	0.440	0.808
AST (U/L)
≤ 40/> 40	23/84	8/16	8/16	7/52	0.947	0.958
ALT (U/L)
≤ 40/> 40	32/75	11/13	8/16	13/46	0.456	0.522
Lipiodol (mL)
≤ 10/> 10	62/45	11/13	15/9	36/32	0.997	0.369

Exp(B) stands for relative risk (RR). M: Male; F: Female; MELD: Model for End-stage Liver Disease; BCLC: Barcelona Clinic Liver Cancer Group; CLIP: Cancer of the Liver Italian Program; ALB: Albumin; TACE: Transarterial chemoembolization; CPT-11: Chemotherapeutic agent irinotecan; GEM: Gemcitabine; 5-FU: 5-fluorouracil oxalate; HBV: Hepatitis B virus; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; BCLC: Barcelona Clinic Liver Cancer; OS: Oxidative stress.

Table 2 Univariate and multivariate analysis for the factors that influence tumor progression

Factors	Univariate (P value)	Multivariate (P value)	Exp(B)	95%CI
Cirrhosis of the liver
Absent/Present	0.025	0.928	1.070	0.242-4.729
Pathological stage
I/II/III/IV	0.022	0.021	0.643	0.442-0.936
TACE Sessions
≤ 2/> 2	0.009	0.083	1.272	0.969-1.670
BCLC Stage
A/B/C	0.006	0.666	1.241	0.465-3.316
Number of Tumor
Single/Multiple	0.039	0.734	0.839	0.305-2.309
CLIP Score
≤ 2/> 2	0.013	0.466	0.822	0.485-1.392
Chemotherapy agent
CPT-11/GEM/Doxorubicin	0.020	0.648	0.869	0.474-1.591
PS score
1/2/2000	0.029	0.032	0.095	0.011-0.818

Exp(B) stands for relative risk (RR). TACE: Transarterial chemoembolization; BCLC: Barcelona Clinic Liver Cancer Group; CLIP: Cancer of the Liver Italian Program; CPT-11: Chemotherapeutic agent irinotecan; GEM: Gemcitabine.

Table 3 Univariate and multivariate analysis for the factors influencing survival rate

Factors	Univariate (P value)	Multivariate (P value)	Exp(B)	95%CI
Cirrhosis of the liver
Absent/Present	0.003	0.083	5.114	0.806-32.436
Pathological Stage
I/II/III/IV	0.013	0.012	0.485	0.276-0.851
TACE Sessions
≤ 2/> 2	0.001	0.001	1.964	1.311-2.942
BCLC Stage
A/B/C	0.005	0.061	0.183	0.031-1.078
Number of Tumor
Single/Multiple	0.017	0.460	1.651	0.437-6.235
CLIP Score
≤ 2/> 2	0.013	0.982	0.992	0.496-1.985
Chemotherapy agent
CPT-11/GEM/Doxorubicin	0.004	0.019	0.407	0.192-0.863
ALB (g/L)
≤ 40/> 40	0.033	0.030	0.834	0.709-0.982

TACE: Transarterial chemoembolization; BCLC: Barcelona Clinic Liver Cancer Group; CLIP: Cancer of the Liver Italian Program; GEM: Gemcitabine; CLIP: Cancer Liver Italian Program; ALB: Albumin; CPT-11: Chemotherapeutic agent irinotecan; GEM: Gemcitabine.

Table 4 Treatment-related toxicity

	Grade I/II/III/IV
	GEM	CPT-11	Doxorubicin
Aminotransferase elevation	2/4/2/0	4/2/0/0	7/2/1/0
Hyperbilirubinemia	1/0/0/0	1/0/0/0	2/0/0/0
Gastrointestinal toxicity	1/0/0/0	2/0/0/0	0/1/0/0
Post-embolization symptom	3/2/0/0	3/3/0/0	7/5/0/0
Bone marrow inhibition	4/5/3/2	2/1/2/1	8/5/4/0
Diarrhea	0/0/0/0	1/1/0/0	0/0/0/0

GEM: Gemcitabine; CPT-11: Chemotherapeutic agent irinotecan.