Application of chemosensitivity test in regional chemotherapy for hepatocellular carcinoma via hepatic artery and portal vein

Objective To evaluate the chemosensitivities of hepatocellular carcinoma (HCC) to different chemotherapy drugs by 3- (4, 5-dimethylthiazol-2-yl) -2, 5-diphenyl-2H tetrazolium bromide (MTT) assay and to provide guidance for individualized chemotherapy regimen in regional chemotherapy via the hepatic artery and portal vein.Methods Forty-two HCC samples were selected.Primary culture of HCC cells combined with MTT assay were used to evaluate the chemosensitivities of HCC to 5-fluorouracil (5-FU) , cisplatin (DDP) , mitomycin C (MMC) , adriamycin (ADM) , hydroxycamptothecine (HCPT) , gemcitabine (Gemzar) , and oxaliplatin (OXA) .Individualized chemotherapy regimens were developed according to the chemosensitivity test results to guide regional chemotherapy via the hepatic artery and portal vein in 24 of these patients (as an individualized chemotherapy group) .The therapeutic efficacy was compared with that of transcatheter arterial infusion performed in 20 patients (as a control group) .The chi-square test was used for comparison of sensitivity rate, and the rank-sum test was used for comparison of time to progression (TTP) .Results The sensitivity rates of HCC were 64.3% to OXA, 45.2% to HCPT, 40.5% to DDP, 38.1% to Gemzar, 33.3% to ADM, 21.4% to 5-FU, and 16.7% to MMC.Compared with the control group, the individualized chemotherapy group had a significantly higher objective response rate (50.0% vs 20.0%, P= 0.039) , a significantly higher disease control rate (70.8% vs 35.0%, P = 0.017) , and a significantly longer TTP ( (4.7±2.9) m vs (2.6±1.3) m, P = 0.032) .Conclusion In vitro chemosensitivity test based on MTT assay may be used to screen out the chemotherapy drugs in individualized chemotherapy for HCC and provide guidance for regional chemotherapy via the hepatic artery and portal vein, so as to improve the effect of chemotherapy.