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Annals of Oncology Advance Access originally published online on June 5, 2009
Annals of Oncology 2009 20(8):1402-1407; doi:10.1093/annonc/mdp010
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

gastrointestinal tumors

Combination chemotherapy with capecitabine and cisplatin for patients with metastatic hepatocellular carcinoma

J. O. Lee1, K. W. Lee2, D. Y. Oh1,3,*, J. H. Kim2, S. A. Im1,3, T. Y. Kim1,3 and Y. J. Bang1,3

1 Department of Internal Medicine, Seoul National University Hospital
2 Department of Internal Medicine, Seoul National University Bundang Hospital
3 Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea

* Correspondence to: Dr D. Y. Oh, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongondong Chongno-gu, Seoul 110-744, Korea. Tel: +82-2-2072-0701; Fax: +82-2-762-9662; E-mail: ohdoyoun{at}snu.ac.kr

Background: We evaluated the efficacy and toxicity of combination chemotherapy with capecitabine and cisplatin (XP) in patients with metastatic hepatocellular carcinoma (HCC).

Patients and methods: From September 2003 to July 2007, we enrolled patients with HCC who had more than one measurable extrahepatic metastatic lesion. Patients received oral capecitabine (2000 mg/m2/day) with a schedule of 2 weeks on and 1 week off and cisplatin (60 mg/m2) on the first day of the 3-week cycle.

Results: The study cohort consisted of 32 patients with a median age of 53 years. Overall response rate was 6.3% and disease control rate was 34.4%. The median time to progression (TTP) was 2.0 months [95% confidence interval (CI) 1.5–2.4] and the median overall survival (OS) time was 12.2 months (95% CI 6.5–17.8). The grade 3/4 hematologic toxic effects included thrombocytopenia (7.6%), neutropenia (4.3%) and anemia (2.1%). The grade 3/4 non-hematologic toxic effects included elevated hepatic aminotransferase (12.9%), jaundice (3.2%), mucositis (3.2%) and nausea (3.2%). There was no treatment-related mortality.

Conclusions: Based on the observed response rate and TTP, XP combination chemotherapy showed modest antitumor efficacy in patients with metastatic HCC as systemic first-line treatment. However, XP combination chemotherapy showed tolerable toxicity and demonstrated favorable OS time.

Key words: capecitabine, cisplatin, hepatocellular carcinoma, metastasis

Received for publication July 13, 2008. Revision received November 26, 2008. Accepted for publication January 8, 2009.


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