Cancer Res Treat.  2010 Dec;42(4):203-209.

Cisplatin-Based Combination Chemotherapy for Advanced Hepatocellular Carcinoma: A Single Center Experience before the Sorafenib Era

• Kim NY
• Sun JM
• Kim YJ
• Lee KW
• Kim JH
• Bang SM
• Kim JW
• Jeong SH
• Lee JS

Abstract

PURPOSE
Systemic chemotherapy is the only option for patients with unresectable/metastatic hepatocellular carcinoma (HCC) who are not candidates for local/regional treatment. However, the response to such treatment and survival are poor, especially in hepatitis B virus (HBV) endemic areas. The aim of this study was to determine the efficacy of cisplatin-based combination chemotherapy and identify a subgroup of advanced HCC patients with favorable responses.
MATERIALS AND METHODS
The medical records of all consecutive patients with unresectable/metastatic HCC who received cisplatin-based combination chemotherapy between January 2003 and October 2009 were reviewed. Time to progression (TTP) and overall survival (OS) were determined using Kaplan-Meier analysis. Univariate and multivariate analyses were performed to identify prognostic factors for TTP and OS.
RESULTS
Data for 46 patients were analyzed. First-line chemotherapies consisted of cisplatin-based combination treatment with doxorubicin, fluoropyrimidines and gemcitabine. The response rate for all patients was 4.3%. The median TTP and OS were 1.8 (95%confidence interval [CI], 1.1 to 2.5) and 7.2 (95% CI, 3.0 to 11.5) months, respectively. Eastern Cooperative Oncology Group (ECOG) performance status (PS), Child classification, Cancer of the Liver Italian Program (CLIP) score and portal vein thrombosis (PVT) were identified by univariate analyses as prognostic factors for TTP and OS. ECOG PS (hazard ratio [HR], 4.51; 95% CI, 1.61 to 12.6; p=0.004) and PVT (HR, 2.12; 95% CI, 1.10 to 4.11; p=0.026) were independent prognostic factors for TTP.
CONCLUSION
Cisplatin-based combination chemotherapy in patients with advanced HCC has a low response rate and short TTP regardless of the chemotherapy regimen used. Patients with a good ECOG PS and without PVT can be considered candidates for cisplatin-based combination chemotherapy.

Keyword

Hepatocellular carcinoma; Platinum; Prognosis; Chemotherapy; Survival

MeSH Terms

Carcinoma, Hepatocellular
Child
Deoxycytidine
Doxorubicin
Drug Therapy, Combination
Hepatitis B virus
Humans
Kaplan-Meier Estimate
Liver Neoplasms
Medical Records
Multivariate Analysis
Niacinamide
Phenylurea Compounds
Platinum
Portal Vein
Prognosis
Thrombosis
Thymine Nucleotides
Deoxycytidine
Doxorubicin
Niacinamide
Phenylurea Compounds
Platinum
Thymine Nucleotides

Figure

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  Fig. 1 (A) Time to progression according to Eastern Cooperative Oncology Group (ECOG) performance status. (B) Overall survival in patients with and without portal vein thrombosis (PVT).

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