Comparison of two transarterial chemoembolization regimens in patients with unresectable hepatocellular carcinoma: raltitrexed plus oxaliplatin versus 5-fluorouracil plus oxaliplatin.

Objective: To compare the safety and efficacy of TACE using raltitrexed, oxaliplatin and epirubicin with 5-fluorouracil, oxaliplatin and epirubicin for patients with unresectable hepatocelluar carcinoma. Results: Median overall survival (OS) was 7.4 months in the raltitrexed group [95% confidence interval (CI): 5.4, 9.4) and 5.8 months in the control group (95% CI: 5.2, 6.4; P = 0.177). The median progression-free survival (PFS) time was significantly higher in the raltitrexed group (3.6 months, 95% CI: 2.8, 4.4) than in the control group (2.6 months, 95% CI: 2.2, 3.0; P = 0.038). The disease control rate (DCR) was higher in the raltitrexed group than in the control group (40% versus 30.4%; P = 0.353). The incidence of adverse events was similar between the two groups.

Methods: From January 2012 to December 2014, 86 patients with unresectable HCC were treated with TACE using the combination of raltitrexed, oxaliplatin and epirubicin (raltitrexed group), and the combination of 5-fluorouracil, oxaliplatin and epirubicin (control group). The primary endpoint was OS, and the secondary endpoints were PFS, DCR and adverse events.

Conclusions: Although the study did not meet its primary endpoint, raltitrexed group reach a higher PFS, which suggests that this combination regimen of TACE as alternative may confer some benefits to selected patients.