Efficacy and Toxicity of Intra-Arterial Cisplatin and Etoposide for Advanced Hepatocellular Carcinoma

OBJECTIVE: To analyze the results of an intra-arterially delivered combination chemotherapy in a group of patients with regionally advanced hepatocellular carcinoma (HCC). METHODS: 26 patients with proven locally advanced HCC treated with hepatic artery infusion of cisplatin (20 mg/m(2), days 1-5) and etoposide (75 mg/m(2), days 1-5) every 4 weeks were retrospectively studied. RESULTS: In an intention-to-treat analysis, overall and complete response rates were 38 and 7%, respectively. Median duration of response was 5 months. Median survival time was 10 months and survival rates at 6, 12 and 24 months were 53, 33 and 24%, respectively. Survival was significantly longer for responders than for non-responders (median: 13 and 3 months, respectively). There were 4 treatment-related deaths among cirrhotics. CONCLUSIONS: Intra-arterial chemotherapy using cisplatin and etoposide seems to have some anti-tumor effect against advanced HCC, although a high rate of life- threatening complications precludes the indication of this regimen at least for patients with non-compensated cirrhosis.