Efficacy of hepatic arterial infusion chemotherapy in advanced hepatocellular carcinoma

Table 1 Baseline characteristics n (%)

Characteristics	IA-FUDR (n = 34)
Age (yr)	62.2 ± 7.4
Sex
Male	27 (79.4)
Female	7 (20.6)
Cause of HCC
Hepatitis B virus	27 (79.4)
Hepatitis C virus	2 (5.9)
Alcoholism	5 (14.7)
Child-Pugh classification
Child class A	7 (20.6)
Child class B	18 (52.9)
Child class C	9 (26.5)
Portal vein thrombosis
Yes	18 (52.9)
No	16 (47.1)
Tumor morphology
Multinodular	16 (47.1)
Huge, massive > 50% of liver	18 (52.9)
Bilirubin (mg/dL)	2.6 ± 2.3
Albumin (g/dL)	2.8 ± 1.1
Prothrombin time (INR)	2.0 ± 0.7
AFP (ng/mL)	5136.03 (median)
Treatment prior to chemotherapy or supportive care
Surgery	0 (0)
RFA	3 (8.8)
TACE	20 (58.8)
RFA and TACE	1 (2.9)
Radiation	1 (2.9)
No treatment	9 (26.5)

HCC: Hepatocellular carcinoma; AFP: Alpha-fetoprotein; RFA: Radiofrequency ablation; TACE: Transarterial chemoembolization; IA-FUDR: Intra-arterial floxuridine; INR: International normalized ratio.

Table 2 Treatment response rate n (%)

Tumor response	Intra-arterial FUDR chemotherapy
	Total	Child class A	Child class B	Child class C
CR	2 (5.9)	1 (14.3)	1 (5.6)	0 (0)
PR	12 (35.3)	2 (28.6)	9 (50)	1 (11.1)
SD	7 (20.6)	2 (28.6)	3 (16.7)	2 (22.2)
PD	13 (38.2)	2 (28.6)	5 (27.8)	6 (66.7)
Response rate	14 (41.2)	3 (42.9)	10 (55.6)	1 (11.1)
Disease control rate	21 (61.8)	5 (71.4)	13 (72.2)	3 (33.3)
Total	34 (100)	7 (100)	18 (100)	9 (100)

FUDR: Floxuridine; CR: Complete response; PR: Partial response; SD: Stable disease; PD: Progressive disease.

Table 3 Prognostic significance of the clinical factors influencing survival

Multivariate	Hazard ratio	95% CI	P value
Age (≥ 60 yr, < 60 yr)	1.381	0.403-4.734	0.608
Sex (male, female)	1.462	0.433-4.937	0.541
Child-Pugh classification	3.710	1.490-9.238	0.005
Portal vein thrombosis (without, with)	0.086	0.019-0.387	0.001
Extent of HCC	0.185	0.051-0.679	0.011
(multinodular, massive > 50% of liver)
Bilirubin (≥ 3, < 3)	0.837	0.319-2.195	0.718
Albumin (< 3, ≥ 3)	1.059	0.430-2.603	0.901
PT INR (< 2.3, ≥ 2.3)	0.218	0.066-0.715	0.012

HCC: Hepatocellular carcinoma; PT INR: Prothrombin time international normalized ratio.

Table 4 Adverse reactions to floxuridine n (%)

Treatment group (toxicity)	NCI-CTC grade
	1-2	3-4
Fever	2 (5.9)	0 (0)
Nausea/vomiting	0 (0)	0 (0)
Gastric or duodenal ulcer	3 (8.8)	4 (11.8)
Mucositis	4 (11.8)	3 (8.8)
Diarrhea	4 (11.8)	3 (8.8)
Leukopenia	2 (5.9)	1 (2.9)
Thrombocytopenia	2 (5.9)	1 (2.9)
Bilirubin elevation	4 (11.8)	1 (2.9)
AST/ALT elevation	5 (14.7)	1 (2.9)
BUN/Cr elevation	0 (0)	1 (2.9)
Catheter infection	1 (2.9)
Total	19	9

NCI-CTC: National Cancer Institute Common Toxicity Criteria; AST: Aspartate transaminase; ALT: Alanine transaminase; BUN: Blood urea nitrogen; Cr: Creatinine.