hepatic arterial infusion chemotherapy with cisplatin for tace-refractory or -ineligible hepatocellular carcinoma with child-pugh score of 8 or above

Background: this study aimed to retrospectively assess the safety and usefulness of hepatic arterial infusion chemotherapy (haic) with cisplatin in patients with hepatocellular carcinoma (hcc) and child-pugh (c-p) score≥ 8, who were refractory to or ineligible for transcatheter arterial chemoembolization (tace). methods: in this study, 28 cisplatin-naïve patients with hcc, c-p score ≥ 8, and no evidence of extrahepatic lesions were treated using haic with cisplatin between july 2004 and july 2013. results: of 28 patients, 10 were refractory to tace and 18 ineligible for tace. in terms of c-p score, 17 patients had a score of 8, 6 a score of 9, and 5 a score of 10. the injected dose of cisplatin was reduced in 64.3% of cases. the overall response rate was 10.7%, with a disease control rate of 35.7%. overall, median survival time (mst) and progression-free survival were 186 and 80 days, respectively. in patients with macroscopic vascular invasion (mvi-positive; n = 9), these values decreased to 161 and 72 days, respectively; while they increased to 341 and 87 days, respectively, in mvi-negative patients (n = 19). patients achieving partial response (pr) and stable disease (sd) status as well as those achieving sd status showed significantly better survival than patients with progressive disease (pd status): pr + sd vs. pd: mst = 447 vs. 123 days, p < 0.001; sd vs. pd: mst = 447 vs. 123 days, p = 0.001). no serious adverse event or treatment-related death occurred. conclusions: haic with cisplatin can be safely administered in patients with hcc and c-p score ≥ 8, who are tace-refractory or -ineligible. an extended survival time is expected when the treatment outcome is either sd or more favorable.