Hepatic Arterial Infusion Oxaliplatin Plus Oral S-1 Chemotherapy in Gastric Cancer with Unresectable Liver Metastases: A Case Series and Literature Review

Abstract

Kangxin Wang,1,2,* Xuebin Zhang,3,* Jia Wei,1 Yiwen Xu,4 Qin Liu,1 Jiaqi Xie,1 Lihua Yuan,3 Zhichen Sun,1 Siyi Tan,1 Lianru Zhang,1 Baorui Liu,1 Yang Yang1 1The Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing 210008, People’s Republic of China; 2Department of Oncology, Nanjing Pukou Central Hospital, Nanjing 211800, People’s Republic of China; 3Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, People’s Republic of China; 4The First Medical School of Nanjing Medical University, Nanjing 210000, People’s Republic of China *These authors contributed equally to this workCorrespondence: Yang YangThe Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, 321 Zhongshan Road, Nanjing 210008, People’s Republic of ChinaTel [phone]Fax [phone]Email [email protected]: The use of hepatic artery infusion (HAI) as a regional therapy against liver metastasis has rarely been reported in gastric cancer. This study aimed to evaluate the efficacy and safety of HAI oxaliplatin plus oral S-1 chemotherapy in first-line palliative therapy for gastric cancer with multiple liver metastases (GCLM).Methods: We reviewed the records of five patients with GCLM who received HAI oxaliplatin (70– 80 mg/m2 2 hrs d1,15) administered via a port-catheter system and S-1 with oral (35– 40 mg/m2 twice daily for d1-14, 28 days for one cycle). Follow-up examination and efficacy evaluation were executed periodically.Results: Until the 4th cycle response evaluation, the local effective rate and control rate were 40% and 80%, respectively; only one patient developed progression. HAI chemotherapy had a better local control against liver metastases (median progression-free survival: hepatic, 8.8 months vs. extrahepatic, 6.2 months), accompanied by less systemic toxicity, decreased tumour markers and symptomatic relief.Conclusion: HAI oxaliplatin plus oral S-1 chemotherapy can be considered as a new choice of first-line treatment for GCLM, which is also a good approach for controlling extrahepatic lesions with less adverse events.Keywords: gastric cancer with multiple liver metastases, nonresectional regional therapy, hepatic arterial infusion, port-catheter system, response evaluation, adverse events

Keywords

• gastric cancer with multiple liver metastases
• nonresectional regional therapy
• hepatic arterial infusion
• port-catheter system
• response evaluation
• adverse events