High dose regional chemotherapy in advanced hepatocellular carcinoma with 4-lumen-2-balloon catheter

Hwang, Y J; Kim, J W; Kim, Y I

Abstract

BACKGROUND: Surgical resection is the mainstay for treatment of HCC. However, resction is often not feasible in patients with advanced HCC. Patients excluded from surgery, may be treated with systemic chemotherapy, but the response is often poor and systemic toxicity is severe. To improve this situation, we evaluated the results and feasibility of percutaneous isolated liver chemoperfusion and charcoal hemoperfusion(HVI-CHP) in patients with multiple advanced HCC.
METHODS
Doxorubicin(200mg) or cisplatinin(250mg) was administrated via the hepatic artery and was eliminated extracorporeally by HVI-CHP in 8 consecutive patients with advanced HCC. By using single 4-lumen-2-balloon catheter, we isolated and captured hepatic venous outflow and, at the same time, directed the filtered blood to the right atrium.
RESULTS
Complete remission was achieved in one patient who showed disappearance of tumors without any evidence of recurrence for 14 months of follow-up period. One patient died of pulmonary metastasis after 8 month of treatment. Six other patients showed stable disease without progression of tumors during follow-up period(mean: 7.7 months). The treatment was well-tolerated in all patients with mild side effects such as 1 mild leukopenia, 1 nausea, and 1 lymphocele in inguinal wound.
CONCLUSION
Although the follow-up period is short and the cohort of patients is small, the percutaneous isolated liver chemoperfusion with 4-lumen-2-balloon catheter may be an effective and less invasive palliative treatment in selected patients with multiple advanced HCC.