Comparison of Intra-Arterial Chemotherapy with Gemcitabine or Floxuridine Followed by TACE with Oxaliplatine

To investigate the efficacy and safety of a gemcitabine plus oxaliplatin combination regimen anda floxuridine plus oxaliplatin combination regimen used in transcatheter arterial chemoembolization for patients withinoperable hepatocellular carcinoma (HCC).Methods: From October 2005 to October 2008, 122 chemonaïve patients with newly diagnosed, inoperable HCC wererandomized into a gemcitabine plus oxaliplatin combination regimen group (GO group) or a floxuridine plus oxaliplatincombination regimen group (FO group). The GO group was treated with 1,600 mg of gemcitabine and 200 mg of oxaliplatin,and the FO group was treated with 1,000 mg of floxuridine and 200 mg of oxaliplatin. Both groups were treated withglutin and iodolipol as the embolic agent in the transcatheter arterial chemoembolization (TACE).Results: The progression-free survival, the median survival period, and the median time to progress had no significantdifference between the two groups. However, there was a significant difference in the incidence of grade 3/4 thrombocytopeniabetween the two groups (P = 0.002). Grade 3/4 hematologic toxicity was observed only in the GO group. Onepatient (1.7%) with grade 3/4 leukopenia and 6 patients (10%) with grade 3/4 thrombocytopenia were observed. Amultivariate analysis revealed that the Eastern Cooperative Oncology Group (ECOG) scores and portal vein thrombosiswere the only independent prognostic factors that affected progression-free survival.Conclusions: The floxuridine plus oxaliplatin combination regimen was tolerated better than the gemcitabine plus oxaliplatincombination regimen used in TACE.