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.
王乐天,张庆,陈虹,田彦,毛莎,白兰. 进展期肝癌肝移植术后采用奥沙利铂联合氟尿嘧啶-甲酰四氢叶酸钙辅助化疗的安全性[J]. 武警医学, 2013, 24(4): 289-292.
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. Med. J. Chin. Peop. Armed Poli. Forc., 2013, 24(4): 289-292.