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Efficacy of hepatic arterial infusion chemotherapy in combination with irradiation for advanced hepatocellular carcinoma with portal vein invasion

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Abstract

Background

The presence of portal vein tumor thrombosis (PVTT) is a poor prognostic factor for patients with hepatocellular carcinomas (HCC). The purpose of this study was to determine the treatment effect of irradiation in combination with hepatic arterial infusion chemotherapy (HAIC) for these patients.

Methods

We retrospectively examined the outcome of 67 HCC patients with PVTT of the main trunk or first branch who received HAIC alone or with concurrent irradiation for PVTT (CCRT).

Results

Thirty-four patients received HAIC, and 33 patients received CCRT. The time to progression (TTP) of PVTT in the CCRT group was significantly longer than in the HAIC group (p < 0.01), and the TTP of intrahepatic nodules in the CCRT group tended to be longer than in the HAIC group (p = 0.06). The objective response rates of intrahepatic nodules (52 vs. 18 %, p < 0.01) and PVTT (45 vs. 18 %, p = 0.01) were both significantly higher in the CCRT group than in the HAIC group, respectively. No significant difference in overall survival was found between the two groups (p = 0.14); however, the median survival time in the CCRT group was longer than that in the HAIC group (12.4 vs. 5.7 months, respectively).

Conclusions

CCRT might be a promising treatment for advanced-stage HCC with PVTT. CCRT prolonged the TTP of intrahepatic nodules and PVTT, and it improved the objective response rate of intrahepatic nodules and PVTT.

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Compliance with ethical requirements and Conflict of interest

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was obtained from all patients for being included in the study. This article does not contain any studies with animal subjects. Kazuhiro Nouso and Hideki Onishi belong to a donation-funded department (Department of Molecular Hepatology, funded by MSD). Kazuhide Yamamoto, Susumu Kanazawa, Kohsaku Sakaguchi, Akinobu Takaki, Yoshiyuki Kobayashi, Hidenori Shiraha, Shinichiro Nakamura, Yasuhiro Miyake, Kuniaki Katsui, Tetsuya Yasunaka, Kenji Kuwaki, Yasuto Takeuchi, Koji Miyahara, Nozomu Wada and Yuki Morimoto declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Molecular Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama City, Okayama, 700-8558, Japan

    Hideki Onishi & Kazuhiro Nouso

  2. Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama City, Okayama, 700-8558, Japan

    Shinichiro Nakamura, Nozomu Wada, Yuki Morimoto, Koji Miyahara, Yasuto Takeuchi, Kenji Kuwaki, Tetsuya Yasunaka, Yasuhiro Miyake, Hidenori Shiraha, Akinobu Takaki & Kazuhide Yamamoto

  3. Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama City, Okayama, 700-8558, Japan

    Kuniaki Katsui

  4. Department of Gastroenterology, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji City, Tokyo, 193-0998, Japan

    Yoshiyuki Kobayashi

  5. Department of Internal Medicine, Fukuyama City Hospital, 5-23-1 Zao-cho, Fukuyama City, Hiroshima, 721-8511, Japan

    Kohsaku Sakaguchi

  6. Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama City, Okayama, 700-8558, Japan

    Susumu Kanazawa

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  1. Hideki Onishi
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  2. Kazuhiro Nouso
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  3. Shinichiro Nakamura
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  5. Nozomu Wada
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  7. Koji Miyahara
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  8. Yasuto Takeuchi
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  9. Kenji Kuwaki
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  10. Tetsuya Yasunaka
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  14. Yoshiyuki Kobayashi
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  15. Kohsaku Sakaguchi
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  16. Susumu Kanazawa
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  17. Kazuhide Yamamoto
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Corresponding author

Correspondence to Hideki Onishi.

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Onishi, H., Nouso, K., Nakamura, S. et al. Efficacy of hepatic arterial infusion chemotherapy in combination with irradiation for advanced hepatocellular carcinoma with portal vein invasion. Hepatol Int 9, 105–112 (2015). https://doi.org/10.1007/s12072-014-9592-y

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  • DOI: https://doi.org/10.1007/s12072-014-9592-y

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