Evaluate treatment results of ctace combine with intratumoral injection of cisplatin in hepatocellular carcinoma with major portal vein thrombosis

Dr Do Dang Tan1, Dr Trinh Ha Chau1, Dr Vu Dang Luu1, professor Pham Minh Thong1, Dr Ngo Le Lam2
1 Radiology Center BV Bach Mai
2 Radiology Center - K Tan Trieu Hospital

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Abstract

Advanced stage hepatocellular carcinoma with portal vein thombosis has worse prognosis and limited treatment. Transarterial
chemoembolization use Lipiodol combined Cisplatin intratumoral is a safe method and have efficacy in treatment.
Objective: To evaluate safety and efficay of cTACE combine with intratumoral injection of Cisplatin for hepatocellular carcinoma with major portal vein shunt treatment.
Methods: From May 2018 to May 2019, 24 patients who had diagnosis of HCC with major portal vein thrombosis were perfomed cTACE (Famorubicin + Lipiodol) combined with intratumoral injection of Cisplatin. The patients were followed after treatment 1 week for the clinical symptom and after 1 month, used mRECIST and tumor markers (AFP or PIVKA-II) to aveluated treatment efficacy. The patients were perfomed consecutive courses of treatment and followed until died or until the end of study.
Results: 24 patients (21 males, 3 females), age mean is 54,4 (from 32ys to 72ys, AFP mean 15600 ng/ml (from 3 to 121000), 19
patients (79%) has size of tumor ≥5cm. The classification of portal vein thrombosis: 6 patients Vp1 and Vp2; Vp3 18 patients. Total courses of treatment was 38 times. 15 patients (62,5%) had post embolization syndrome, 8 patients (33,3%) had decreasing of tumor marker. mRECIST: CR 3 patients (12,5%); PR 6 patients (25%); SD 4 patients (16,7%); PD 11 patients (45,8%). The mean survival time was 9,9 ± 1,1 months. The survival times is depend on the classification of PVTT (p=0.037 the
mRECIST respondsibility (p=0.0001), the decreasing of tumor markers (p=0.01) and isn’t depend on the AFP before procedures.
Conclusions: cTACE combine with intratumoral injection of Cisplatin is safety an have efficacy on treatment of HCC with major
portal vein thrombosis.

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