Highlights
- •Hepatic arterial infusion was proven to be an effective and safe treatment in advanced HCC.
- •Hepatic arterial infusion therapy was an independent factor for PFS and OS.
- •Hepatic arterial infusion therapy provided a potential benefit of survival in patients with advanced HCC.
Background & Aims
To compare the overall survival (OS) and disease progression free survival (PFS) in
patients with advanced hepatocellular carcinoma (Ad-HCC) who are undergoing hepatic
arterial infusion (HAI) of oxaliplatin, fluorouracil/leucovorin (FOLFOX) treatment
vs. sorafenib.
Methods
This retrospective study was approved by the ethical review committee, and informed
consent was obtained from all patients before treatment. HAI of FOLFOX (HAIF) was
recommended as an alternative treatment option for patients who refused sorafenib.
Of the 412 patients with Ad-HCC (376 men and 36 women) between Jan 2012 to Dec 2015,
232 patients were treated with sorafenib; 180 patients were given HAIF therapy. The
median age was 51 years (range, 16–82 years). Propensity-score matched estimates were
used to reduce bias when evaluating survival. Survival curves were calculated by performing
the Kaplan-Meier method and compared by using the log-rank test and Cox regression
models.
Results
The median PFS and OS in the HAIF group were significantly longer than those in the
sorafenib group (PFS 7.1 vs. 3.3 months [RECIST]/7.4 vs. 3.6 months [mRECIST], respectively; OS 14.5 vs. 7.0 months; p <0.001 for each). In the propensity-score matched cohorts (147 pairs), both PFS and
OS in the HAIF group were longer than those in the sorafenib group (p <0.001). At multivariate analysis, HAIF treatment was an independent factor for PFS
(hazard ratio [HR] 0.389 [RECIST]/0.402 [mRECIST]; p <0.001 for each) and OS (HR 0.129; p <0.001).
Conclusion
HAIF therapy may improve survival compared to sorafenib in patients with Ad-HCC. A
prospective randomized trial is ongoing to confirm this finding.
Lay summary
We compared the hepatic arterial infusion of FOLFOX (a combination chemotherapy) with
sorafenib (a tyrosine kinase inhibitor) in patients with advanced hepatocellular carcinoma,
retrospectively. It was found that hepatic arterial infusion of FOLFOX therapy may
improve both progression free and overall survival in patients with advanced hepatocellular
carcinoma.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: February 19, 2018
Accepted:
February 3,
2018
Received in revised form:
November 1,
2017
Received:
June 21,
2017
Identification
Copyright
© 2018 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
