The Retrospective Study Of Safety And Efficacy Of The Oxaliplatin-based FOLFOX Protocol To Perform Hepatic Arterial Infusion Chemotherapy For Hepatocellular Carcinoma

Objective To evaluate the safety and efficacy of hepatic arterial infusion chemotherapy(HAIC)with oxaliplatin combined with 5-fluorouracil and other drugs in the treatment of hepatocellular carcinoma(HCC).Methods 32 patients with hepatocellular carcinoma were included in this study.These patients received oxaliplatin-based FOLFOX-HAIC between January 2020 and December 2022.The regimen included oxaliplatin diluted with 50-500 mL 5%glucose injection(85 or 130 mg/m2)for 2-3 h,followed by intravenous infusion of calcium folinate 400 mg/m2 for 12 h,then arterial mass injection of 5-fluorouracil 400 mg/m2,and followed by arterial infusion 2400 mg/m2 for 23 h,repeated every 3 weeks.Until the disease progresses or becomes intolerable,treatment such as surgical excision or systemic chemotherapy is used.Overall survival(OS),progression-free survival(PFS),tumor response,tumor markers,and adverse events were studied.Results The surgical conversion rate of 32 patients was 28.1%,that is,9 patients(9/32,28.1%)received surgery only,and 19 patients received other therapies,such as trans-arterial chemoembolization(TACE)or TACE plus chemotherapy,and 4 patients underwent chemotherapy regimen and failed to achieve surgical excision.The median OS was 14.9 months and the median PFS was 11.1 months.PR(partial response)was achieved in 10(31.3%),SD(stable disease)in 19(59.4%),and PD(progressive disease)in 3(9.4%).ORR(objective response rate)was 31.3%and DCR(disease control rate)was 90.6%.No Grade 4 adverse events were found,and 3 patients(11.1%)had Grade 3 adverse events,including hematological system injury(2,6.3%)and liver dysfunction(1,3.1%).In the study of different oxaliplatin doses(130 mg/m2,85 mg/m2)and different oxaliplatin concentrations(≤2.5 mg/mL,>2.5 mg/mL),except that high concentrations were more effective in reducing AFP(P=0.006),there were no other significant differences in the efficacy and safety of the different regimens observed(P>0.05).Conclusion HAIC with oxaliplatin-based FOLFOX regimen is a highly effective and welltolerated treatment for hepatocellular carcinoma,even in those patients who have had prior chemotherapy and/or surgery.In order to facilitate clinical use and improve the comfort level of patients,we recommend doctors to use high-concentration oxaliplatin regimen(>2.5 mg/mL)for treatment.