Remission and survival following monthly intraarterial cisplatinum in nonresectable hepatoma

Precis: Intraarterial delivery of 50 mg/m(2) cisplatinum on a monthly basis is a well-tolerated regimen for patients with nonresectable hepatoma. The selective uptake of cisplatinum delivered intraarterially suggests other selective intraarterial protocols would be of use in regional cancers treated with cisplatinum. Background: Sixty-seven patients with nonresectable hepatoma were treated with hepatic artery infusions (HAI) of 50 mg/m(2) cisplatinum on a monthly basis. Methods: Forty-eight patients received an initial course of whole liver external radiation with intravenous (IV) cisplatinum 50 mg/m(2). Nineteen patients did not receive radiation and received HAI cisplatinum only. All patients then received HAI cisplatinum at 50 mg/m(2) on a monthly basis. Six patients were given a tracer dose of radioactive (195m)cisplatinum for quantitation by the HAI and IV routes. Results: Monthly HAI cisplatinum was well tolerated and could be repeated indefinitely. Median survival for primarily treated nonresectable hepatomas was 12 months [alpha fetoprotein (AFP) elevated] and 17.5 months (AFP negative). Radioactive cisplatinum given by HAI yielded 34-55% tumor uptake of cisplatinum vs. <5% by IV delivery. Conclusions: Hepatic intraarterial cisplatinum at 50 mg/m(2) is a well-tolerated monthly regimen for patients with nonresectable hepatoma.