| Theme | Treatment Strategy for Advanced Hepatocellular Carcinoma | |
|---|---|---|
| Title | Hepatic Arterial Infusion Chemotherapy for Advanced Liver Cancer | |
| Publish Date | 2015/07 | |
| Author | Shuntaro Obi | Gastroenterology and Hepatorology, Kyoundo Hospital, Sasaki Institute |
| Author | Shinpei Sato | Gastroenterology and Hepatorology, Kyoundo Hospital, Sasaki Institute |
| Author | Toshihiro Kawai | Gastroenterology and Hepatorology, Kyoundo Hospital, Sasaki Institute |
| Author | Takahisa Sato | Gastroenterology and Hepatorology, Kyoundo Hospital, Sasaki Institute |
| Author | Takafumi Sugimoto | Gastroenterology and Hepatorology, Kyoundo Hospital, Sasaki Institute |
| Author | Miho Kanda | Gastroenterology and Hepatorology, Kyoundo Hospital, Sasaki Institute |
| [ Summary ] | Liver cancer is the sixth most common cancer worldwide in terms of numbers of cases but because of the very poor prognosis, the number of deaths is almost the same. It is therefore the third most common cause of death from cancer. The majority of these tumors develop in patients who have liver cirrhosis. The development of HCC has an effect on the natural history of liver disease. In spite of screening systems, some HCCs are detected at an advanced stage. An increasing variety of therapeutic options is available for patients with HCC. Many of these options have a survival benefit. However, the long term prognosis of HCC remains disappointing, because recurrence of HCC is frequently encountered, and portal venous invasion of HCC often develops. According to the treatment algorithm for HCC, patients with advanced disease are candidates for sorafenib. However, while sorafenib has been proven to be effective in randomized controlled trials (RCTs), its use has limitations due to severe adverse events. Several other therapies have been evaluated, including hepatic arterial infusion chemotherapy (HAIC). However, there is no RCT evidence that these therapies contribute to prolongation of survival, although marginal effects such as shrinkage of tumor size or decrease of tumor numbers have been observed in selected cases. Several RCTs have been planned to evaluate HAIC using sorafenib as a control. These trials will clarify some of the uncertainties of HAIC. |
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