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Volume 39 Issue 7
Jul.  2023
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Article Navigation >  Journal of Clinical Hepatology  > 2023  >  39(7): 1592-1599

Efficacy of hepatic arterial infusion chemotherapy and its multimodality therapeutic regimens in treatment of patients with advanced hepatocellular carcinoma and related prognostic factors

DOI: 10.3969/j.issn.1001-5256.2023.07.013
  • 1.

    Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangdong Provincial Institute of Liver Diseases, Guangzhou 510515, China

  • 2.

    The First Clinical Medical College, Southern Medical University, Guangzhou 510515, China

Research funding:

Natural Science Foundation of Guangdong Province (2022A1515010526);

President Foundation of Nanfang Hospital, Southern Medical University (2018C006)

More Information
  • Corresponding author: CHEN Jinzhang, chenjinzhang@smu.edu.cn (ORCID: 0000-0003-4964-2218)
  • Received Date: 2022-11-30
  • Accepted Date: 2023-01-06
  • Published Date: 2023-07-20
    Abstract
  •   Objective  To investigate the efficacy of continuous hepatic arterial infusion chemotherapy (HAIC) with the FOLFOX regimen and its multimodality therapeutic regimen in the treatment of patients with advanced hepatocellular carcinoma, as well as the influencing factors for prognosis.  Methods  A retrospective analysis was performed for the clinical data of 66 patients with advanced hepatocellular carcinoma who received continuous HAIC with FOLFOX regimen in Nanfang Hospital, Southern Medical University, from September 2018 to November 2021. The patients were observed in terms of objective response rate (ORR), disease control rate (DCR), median progression-free survival (mPFS), and median overall survival (mOS) after treatment, and treatment-related adverse reactions were recorded. For the patients with portal vein tumor thrombus, the effect of the treatment on portal vein tumor thrombus was assessed. The Kaplan-Meier method was used for survival analysis, and the Cox regression analysis was used to investigate the influencing factors for prognosis.  Results  According to the RECIST1.1 criteria, FOLFOX-HAIC and its multimodality therapeutic regimen achieved an ORR of 33.3% (22/66) and a DCR of 86.4% (57/66) in the treatment of 66 patients with advanced hepatocellular carcinoma, with an mPFS time of 8.2 months and an mOS time of 22.1 months. Among the 39 patients with portal vein tumor thrombus, 2 achieved complete remission, 8 achieved partial remission, 24 achieved stable disease, and 5 had disease progression, with an ORR of 25.6% (10/39) and a DCR of 87.2% (34/39). The main adverse reactions included gastrointestinal reactions (16.7%, 11/66), pyrexia (12.1%, 8/66), liver area pain (10.6%, 7/66), bone marrow suppression (3.0%, 2/66), and contrast agent allergy (3.0%, 2/66), and there were no grade > Ⅳ toxic or side effects or deaths caused by such complications. The Cox regression analysis showed that extrahepatic metastasis (hazard ratio [HR]=2.668, 95% confidence interval [CI]: 1.357-5.245, P < 0.05) and prothrombin time (PT) (HR=1.282, 95%CI: 1.080-1.630, P < 0.05) were independent risk factors for PFS, and aspartate aminotransferase level (HR=1.008, 95%CI: 1.002-1.013, P < 0.05) and PT (HR=1.303, 95%CI: 1.046-1.630, P < 0.05) were independent risk factors for OS.  Conclusion  FOLFOX-HAIC and its multimodality therapeutic regimen has a certain clinical effect with controllable adverse reactions in the treatment of advanced hepatocellular carcinoma.

     

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