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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 7, 2015; 21(13): 3843-3849
Published online Apr 7, 2015. doi: 10.3748/wjg.v21.i13.3843
Hepatic artery infusion chemotherapy for advanced hepatocellular carcinoma
Myeong Jun Song
Myeong Jun Song, Division of Hepatology, Department of Internal Medicine, Daejeon St. Mary’s Hospital, College of Medicine, the Catholic University of Korea, Daejeon 301-723, South Korea
Author contributions: Song MJ solely contributed to this paper.
Conflict-of-interest: There is no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Myeong Jun Song, MD, PhD, Division of Hepatology, Department of Internal Medicine, Daejeon St. Mary’s Hospital, College of Medicine, the Catholic University of Korea, Daeheung-ro 64, Jung-gu, Daejeon 301-723, South Korea. mjsong95@gmail.com
Telephone: +82-42-2209291
Received: November 24, 2014
Peer-review started: November 25, 2014
First decision: December 26, 2014
Revised: January 2, 2015
Accepted: February 5, 2015
Article in press: February 5, 2015
Published online: April 7, 2015
Processing time: 134 Days and 1.6 Hours
Abstract

Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. Surgery, percutaneous ablation and liver transplantation are the only curative treatment modalities for HCC. However, the majority of patients have unresectable disease at diagnosis. Therefore, effective treatment options for patients with advanced HCC are required. In advanced HCC, according to current international guidelines, sorafenib, a molecular targeted agent, is the standard treatment. However, alternative treatment modalities are required because of the low response rates and unsuitability of molecular agents in real practice. In various treatment modalities, mostly in Asia, hepatic arterial infusion chemotherapy (HAIC) has been applied to advanced HCC with a view to increasing the therapeutic efficacy. HAIC provides direct drug delivery into the tumor feeding vessels and also minimizes systemic toxicities through a greater first-pass effect in the liver. However, the sample sizes of studies on HAIC have been small and large randomized trials are still lacking. In this article, we describe the treatment efficacy of HAIC for advanced stage HCC and discuss future therapeutic possibilities.

Keywords: Hepatocellular carcinoma; Advanced stage hepatocellular carcinoma; Sorafenib; Hepatic arterial infusion chemotherapy; Treatment efficacy

Core tip: Sorafenib is the standard of treatment for advanced hepatocellular carcinoma (HCC). However, the suitability of sorafenib is limited by its low response rates, and unsuitability for patients with poor liver function. Therefore, other treatment modalities are required. Hepatic arterial infusion chemotherapy (HAIC) has the advantages of delivering high levels of chemotherapeutic drugs directly into tumor-associated hepatic arterial branches and repeat injections are relatively simple to carry out. Thus the local therapeutic level is increased and systemic adverse effects are decreased. In the future, HAIC may be a promising treatment strategy for the management of advanced HCC.