Safety study of adjuvant chemotherapy with oxaliplatin and 5-Fu and CF after liver transplantation for hepatocellular carcinoma

WANG Letian; ZHANG Qing; CHEN Hong; TIAN Yan; MAO Sha; and BAI Lan.

PDF(891 KB)

Medical Journal of the Chinese People Armed Police Forces ›› 2013, Vol. 24 ›› Issue (4) : 289-292.

Safety study of adjuvant chemotherapy with oxaliplatin and 5-Fu and CF after liver transplantation for hepatocellular carcinoma

WANG Letian,ZHANG Qing,CHEN Hong,TIAN Yan,MAO Sha,and BAI Lan.

Author information +

History +

Abstract

Objective To evaluate the safety of postoperative adjuvant chemotherapy on the recurrence rate and survival of patients for hepatocellular carcinoma (HCC) after liver transplantation (LT). Methods Fifty-eight consecutive HCC patients with liver cirrhosis who did not conform Milancriteria underwent LT. Twenty-six invasive HCC patients were entered into a prospective prophylactic protocol with three week cycles of oxaliplatin plus 5-fluorouracil（5-Fu）and calcium formyltetrahydrofolat (CF) for a maximum of six cycles. The adverse reactions and survival were recorded during treatment and after completion of treatment. Results The 3-year survival in the non-Milan HCC patients with post-LT chemotherapy was 86.2%, and that in the non-Milan HCC patients without post-LT chemotherapy was 53.6%. Myelosuppression was noted in 27 patients, 24 patients had leukopenia and 12 of these needed treatment with granulocyte-colony stimulating factor (G-CSF). Seven patients had thrombocytopenia, only four of whom were treated with recombinant human thrombopoietin. There were no events corresponding to transplant rejection in any of the patients given adjuvant chemotherapy. There were no deaths or severe infections attributable to chemotherapy. The chemotherapy regimen was well tolerated and no one broke off chemotherapy owing to clinical side effects. Conclusions Post-LT adjuvant chemotherapy with oxaliplatin and 5-Fu - CF is safe and feasible in treatment of advanced HCC patients who do not meet the Milan criteria after LT.

Key words

hepatocellular carcinoma / liver transplantation / oxaliplatin / 5-fluorouracil / safety

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

WANG Letian,ZHANG Qing,CHEN Hong,TIAN Yan,MAO Sha,and BAI Lan.. Safety study of adjuvant chemotherapy with oxaliplatin and 5-Fu and CF after liver transplantation for hepatocellular carcinoma[J]. Medical Journal of the Chinese People Armed Police Forces. 2013, 24(4): 289-292

References

［1］ Cillo U, Vitale A, Volk M L, et al. The survival benefit of liver transplantation in hepatocellular carcinoma patients［J］. Dig Liver Dis, 2010, 42(9):642-649.

［2］ Ishizaki Y, Kawasaki S. The evolution of liver transplantation for hepatocellular carcinoma (past, present, and future)［J］. J Gastroenterol, 2008, 43(1):18-26.

［3］ Cescon M, Ravaioli M, Grazi G L, et al. Prognostic factors for tumor recurrence after a 12-year, single-center experience of liver transplantations in patients with hepatocellular［J］. J Transplant, 2010, 10: 9041-9052.

［4］ Chu F, Morris D L. Single centre experience of liver resection for hepatocellular carcinoma in patients outside transplant criteria［J］. Eur J Surg Oncol, 2006 ,32(5):568-572.

［5］ Hsieh C B, Chou S J, Shih M L. Preliminary experience with gemcitabine and cisplatin adjuvant chemotherapy after liver transplantation for hepatocellular carcinoma［J］. Eur J Surg Oncol, 2008,34(8):906-910.

［6］ Vivarelli M,Risaliti A. Liver transplantation for hepatocellular carcinoma on cirrhosis: strategies toavoid tumor recurrence［J］. World J Gastroenterol, 2011, 17(43): 4741-4746.

［7］ Zarrinpar A,Kaldas F,Busuttil RW. Liver transplantation for hepatocellular carcinoma: an update［J］. Hepatobiliary Pancreat Dis Int, 2011, 10(3): 234-242.

［8］孙燕, 周际昌. 临床肿瘤内科手册［M］ . 4 版.北京:人民卫生出版社, 2003: 102- 104.

［9］ Sutcliffe R, Maguire D, Murphy P, et al. Detection and clinical significance of bone marrow micrometastases in patients undergoing liver transplantation for hepatocellular carcinoma［J］. Transplantation, 2005,80(1):88-94.

［10］ Roayaie S, Frischer J S, Emre S H, et al. Long term results with multimodal adjuvant therapy and liver transplantation for the treatment of hepatocellular carcinoma larger than 5 centimeters ［J］ . Ann Surg, 2002, 235(4): 533-539.

［11］ Vexler AM, Mou X, Gabizon AA. Reduction of the systemic toxicity of cisplatin by intra-arterial hepatic route administration for liver malignancies［J］. Int J Cancer, 1995, 60(5):611-615.