Effect of arsenic trioxide chemotherapy on survival time in liver cancer patients undergoing liver transplantation

Objective To investigate whether arsenic trioxide preventive chemotherapy can prolong the survival time of patients with primary liver cancer undergoing liver transplantation. Methods A retrospective analysis was performed for the clinical data of the patients who underwent liver transplantation in Department of Liver Transplantation in Changzheng Hospital from January to December, 2015, and among these patients, 35 ( observation group) received the chemotherapeutic regimen of epirubicin D1 + 5-fluorouracil ( D1-5) and 35 ( control group) received the chemotherapeutic regimen of arsenic trioxide ( D1-14) . Hematological examinations were performed at the beginning and ending of each cycle of treatment, including routine blood test, hepatic and renal function, and tumor markers, and drug side-effects were observed. Chest CT, liver CT, or MRI was performed at the beginning of every two cycles to record tumor recurrence, survival, and death time. The chi-square test was used for comparison of categorical data between groups, the Kaplan-Meier method was used to plot survival curves, and the log-rank test was used to compare survival curves between groups. Results In the observation group, 3 patients experienced a transient increase in alanine aminotransferase after the last chemotherapy; 30 patients experienced the symptoms of water-sodium retention including mild edema in the face and lower limbs in the late stage of treatment, which were improved after diuretic treatment or at the end of treatment. In the control group, 24 patients experienced varying degrees of gastrointestinal reactions such as poor appetite, nausea, and vomiting, which were improved at the end of chemotherapy. The control group had a 1-year survival rate of 85. 7% ( 30/35) , a 2-year survival rate of 47. 4% ( 18/35) , and a 3-year survival rate of 22. 9% ( 8/35) , and the observation group had a 1-year survival rate of 91. 4% ( 32/35) , a 2-year survival rate of 83. 9% ( 26/31) , and a 3-year survival rate of 57. 1% ( 12/21) . There was no significant difference in 1-year survival rate between the two groups ( χ2= 2. 258, P < 0. 05) , and the observation group had significantly higher 2-and 3-year survival rates than the control group ( χ2= 7. 786 and 6. 720, both P < 0. 05) . Survival curves also showed that the observation group had significantly higher 2-and 3-year survival rates than the control group ( χ2= 6. 573, P < 0. 05) . Conclusion Arsenic trioxide has been used for a long time, and with modern and scientific administration, it can improve the survival time of patients with liver cancer undergoing liver transplantation.