- Email: [email protected]
1000 THE OUTCOME OF CYBERKNIFE THERAPY FOR PRIMARY AND METASTATIC LIVER TUMORS : A SINGLE CENTER EXPERIENCE
POSTERS Conclusion: The use of DC-BEADS increased the rate of objective tumoral response in two comparable populations with HCC without increasing the rate of complications, and with a better 2-year survival. 999 SURVIVAL AND TREATMENT RESPONSES FOR HEPATIC ARTERIAL INFUSION CHEMOTHERAPY IN ADVANCED HEPATOCELLULAR CARCINOMA WITH PORTAL VEIN TUMOR THROMBOSIS J.H. Choi, W.J. Chung, E.S. Kim, K.S. Park, K.B. Cho, B.K. Jang, J.S. Hwang. Keimyung University School of Medicine, Daegu, Republic of Korea E-mail: [email protected] Background and Aims: Patient with advanced hepatocellular carcinoma (HCC) with portal vein thrombosis (PVT) has poor prognosis. Median survival time was reported 2.7–4 months if left untreated. Recently, hepatic arterial infusion chemotherapy (HAIT) has been reported as an effective therapeutic modality. The aim of this study was to evaluate survival and treatment responses of HAIT for advanced HCC with PVT. Methods: From January 2004 to November 2011, We reviewed the data of patient with advanced HCC with PVT who received over 2 sessions of HAIT. Tumor response was measured by abdominal CT at each 2 sessions of HAIT using Modified Response Evaluation Criteria for Solid Tumors criteria. Results: 1. 44 patients were enrolled. Mean age was 55 years old (range 46–62) and 37 patients was man. Child-Pugh class of patients were A in 23 (52.3%), B in 19 (43.2%), and C in 2 (4.5%). The causes of HCC were HBV (68.2%), HCV (9.1%), and alcoholics (15.9%). 2. Averagely, patients received 4.1 sessions of HAIT. At the time of 2 sessions of HAIT, the median survival time of patients who achieved complete response (CR), partial response (PR) or stable disease (SD) (Group A) and progressive disease (PD) (Group B) were 145 vs. 89 days. (p = 0.006). At the time of 4 sessions of HAIT, Survival time was 276 vs. 89 days. (p = 0.00), and at time of 6 sessions of HAIT, that were 1160 vs. 91 days. (p = 0.00). 3. Single nodular or massive types HCC had better treatment responses and proloned survival than multinodular or diffuse types. (p = 0.013, p = 0.040). 4. Median survival time was 114 days. The cause of death was hepatic failure, variceal bleeding, hepatic rupture, sepsis, peritonitis. Conclusions: HAIT may be useful therapeutic option for patients with advanced HCC with PVT. And macroscopic finding of HCC seem to be predictive factor for treatment response for HAIT. 1000 THE OUTCOME OF CYBERKNIFE THERAPY FOR PRIMARY AND METASTATIC LIVER TUMORS: A SINGLE CENTER EXPERIENCE H.J. Chung1,2 , J.-W. Lee1 , J.I. Lee1 , Y.C. Choi1 , W.C. Kim3 , Y.S. Kim1 , D.H. Lee1 . 1 Gastroenterology & Hepatobiliary System, Inha University School of Medicine, Incheon, 2 Gastroenterology & Hepatobiliary System, Yonsei University College of Medicine Gangnam Sevrance Hospital, Seoul, 3 Radiation Oncology, Inha University School of Medicine, Incheon, Republic of Korea E-mail: [email protected] Background and Aims: Radiotherapy in the treatment of hepatocellular carcinoma (HCC) has been considered a limited role of the therapeutic option. For the metastatic liver diseases, radiotherapy has been used for palliative modality. Cyberknife(CK) is newly developed hypofractionated stereotactic body radiation therapy (SBRT) which delivers high dose radiation and offers a high precision non-invasive treatment using small margins in the most of solid tumors. The aim of this study was to evaluate the efficacy of CK between the primary HCC and metastatic liver lesions.
Methods: From March 2008 to August 2011, a total forty lesions in the thirty-eight patients were treated with CK in the liver. We reviewed the medical records of these patients retrospectively. Fifteen tumors in thirteen patients were diagnosed primary HCC, and other twenty-five patients were metastatic liver tumors. These two groups were compared according to various clinical features before and after CK therapy. The treatment response was assessed by RECIST criteria. Result: Median follow-up period was 13.7 months (range 0.8–49), median tumor size was 3.2 cm (range 0.4–6.7) and median tumor volume was 73 cm3 (range 4–259). In primary HCC group, median therapeutic CK dose was 5×850 cGy. For the tumor response after CK, complete response (CR) was achieved by 6% (1/15), partial response (PR) by 60% (9/15), stable disease (SD) by 27% (4/15) and by 6%(1/15) progressive disease (PD). The pretreatment median AFP level was 344 ng/ml (range 20–17,104) and postCK median AFP was 78.1 (3.5–2139). In metastatic group, median therapeutic CK dose was 3×1500 cGy. For the tumor response after CK, CR was achieved by 25% (5/20), PR by 45% (9/20), SD by 15% (3/20) and PD by 15% (3/20). There was no serious adverse event in both groups. Conclusion: CK for both primary HCC and metastatic liver tumors is considered safe and effective treatment modality. 1001 EFFICACY AND TOXICITY OF METRONOMIC CAPECITABINE IN ADVANCED HEPATOCELLULAR CARCINOMA A. Farrag1,2 . 1 Clincal Oncology Dept, Faculty of Medicine, Assiut University, Assiut, Egypt; 2 Oncology Center, King Abdullah Medical City, Makkah, Saudi Arabia E-mail: [email protected] Background: Hepatocellular carcinoma (HCC) is a hypervascular tumor. Metronomic chemotherapy; the continuous administration of low-dose chemotherapy; has both cytotoxic and antiangiogenic effects with low toxicity profile. We evaluated the efficacy and toxicity of metronomic capecitabine (MC) in patients with advanced HCC. Patients and Methods: From May 2010, we enrolled pts with either metastatic or locally advanced diseases not candidate for ablative or locoregional treatment and have acceptable liver function. Patients received oral MC in dose of 1000 mg/m2 daily in a 21 days cycle without interruption till disease progression or toxicity. Results: The study cohort consisted of 22 patients with a median age of 63 years. The median number of cycles received was 3 cycles (range 1–9). From 19 patients were evaluable for response we had 3 partial responders, 10 stable diseases and disease progression in 6 patients. Median time to progression (TTP) was 2.2 months (95% CI 1.4–6.24) and median survival time (OS) was 4.8 months (95% CI 1.8–7.9). For 20 patients evaluable for safety: no grade III/IV hematological toxic effects were. Non-hematological toxic effects included grade III vomiting and diarrhea in one patient and grade III hand-foot syndrome in one patient. There was no treatmentrelated mortality. Conclusions: Based on the observed response rate, TTP and OS; MC has a modest antitumor efficacy in pts with advanced HCC. However, due to its low toxicity profile it deserves further attention as a convenient, outpatient-based chemotherapy regimen.This suggests for the future evaluation of MC in combination with other chemotherapeutic agents or with antiangiogenic target therapy known to have activity in HCC.
Journal of Hepatology 2012 vol. 56 | S389–S548
S391
Methods: From March 2008 to August 2011, a total forty lesions in the thirty-eight patients were treated with CK in the liver. We reviewed the medical records of these patients retrospectively. Fifteen tumors in thirteen patients were diagnosed primary HCC, and other twenty-five patients were metastatic liver tumors. These two groups were compared according to various clinical features before and after CK therapy. The treatment response was assessed by RECIST criteria. Result: Median follow-up period was 13.7 months (range 0.8–49), median tumor size was 3.2 cm (range 0.4–6.7) and median tumor volume was 73 cm3 (range 4–259). In primary HCC group, median therapeutic CK dose was 5×850 cGy. For the tumor response after CK, complete response (CR) was achieved by 6% (1/15), partial response (PR) by 60% (9/15), stable disease (SD) by 27% (4/15) and by 6%(1/15) progressive disease (PD). The pretreatment median AFP level was 344 ng/ml (range 20–17,104) and postCK median AFP was 78.1 (3.5–2139). In metastatic group, median therapeutic CK dose was 3×1500 cGy. For the tumor response after CK, CR was achieved by 25% (5/20), PR by 45% (9/20), SD by 15% (3/20) and PD by 15% (3/20). There was no serious adverse event in both groups. Conclusion: CK for both primary HCC and metastatic liver tumors is considered safe and effective treatment modality. 1001 EFFICACY AND TOXICITY OF METRONOMIC CAPECITABINE IN ADVANCED HEPATOCELLULAR CARCINOMA A. Farrag1,2 . 1 Clincal Oncology Dept, Faculty of Medicine, Assiut University, Assiut, Egypt; 2 Oncology Center, King Abdullah Medical City, Makkah, Saudi Arabia E-mail: [email protected] Background: Hepatocellular carcinoma (HCC) is a hypervascular tumor. Metronomic chemotherapy; the continuous administration of low-dose chemotherapy; has both cytotoxic and antiangiogenic effects with low toxicity profile. We evaluated the efficacy and toxicity of metronomic capecitabine (MC) in patients with advanced HCC. Patients and Methods: From May 2010, we enrolled pts with either metastatic or locally advanced diseases not candidate for ablative or locoregional treatment and have acceptable liver function. Patients received oral MC in dose of 1000 mg/m2 daily in a 21 days cycle without interruption till disease progression or toxicity. Results: The study cohort consisted of 22 patients with a median age of 63 years. The median number of cycles received was 3 cycles (range 1–9). From 19 patients were evaluable for response we had 3 partial responders, 10 stable diseases and disease progression in 6 patients. Median time to progression (TTP) was 2.2 months (95% CI 1.4–6.24) and median survival time (OS) was 4.8 months (95% CI 1.8–7.9). For 20 patients evaluable for safety: no grade III/IV hematological toxic effects were. Non-hematological toxic effects included grade III vomiting and diarrhea in one patient and grade III hand-foot syndrome in one patient. There was no treatmentrelated mortality. Conclusions: Based on the observed response rate, TTP and OS; MC has a modest antitumor efficacy in pts with advanced HCC. However, due to its low toxicity profile it deserves further attention as a convenient, outpatient-based chemotherapy regimen.This suggests for the future evaluation of MC in combination with other chemotherapeutic agents or with antiangiogenic target therapy known to have activity in HCC.
Journal of Hepatology 2012 vol. 56 | S389–S548
S391