Determinants of pain in advanced HCC patients recieving hepatic artery infusion chemotherapy
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PRECLINICAL STUDIES
Determinants of pain in advanced HCC patients recieving hepatic artery infusion chemotherapy Zhiqiang Wu 1 & Wenbo Guo 1
&
Song Chen 1 & Wenquan Zhuang 1
Received: 28 July 2020 / Accepted: 21 September 2020 # The Author(s) 2020
Summary Purpose Hepatic arterial infusion chemotherapy (HAIC) is one of the options to treat unresectable hepatocellular carcinoma (HCC). The majority of HCC patients suffer great pain in the course of HAIC treatment. To improve the quality of life and the efficacy of HAIC treatment, the causes of pain, the choice of an analgesic regimen, and the relationship between pain and prognosis of HCC were analyzed. Methods A total of 376 HCC patients under HAIC in our hospital were recriuted between March 2017 and September 2019. Multivariate linear regression analysis (stepwise) was used to calculate the potential factors related to the severe pain in HCC patients under HAIC. Analgesics treatments were carried out based on the results of the visual analogue scale (VAS) score which was used to evaluate the pain. Results The mean value of the VAS score is 3.604, which indicates that the pain in most patients is mild and endurable. Intra-arterial lidocaine injection is an effective method in most patients (96%, 361 of 376), and the total score of VAS is reduced from 1355 to 195 following lidocaine injection. Multivariate analysis suggestes that oxaliplatin (OXA) preparation time, hepatic artery diameter and OXA manufacturers (R2 = 0.859) are influential factors for pain scores. Conclusion This study demonstrates an effective way to systematically assess and ease pain in HCC patients with HAIC treatment. OXA preparation time, hepatic artery diameter, and OXA manufacturers are the potential influencing factors for pain. This work presented here will provide a detailed understanding of the clinical application of HAIC in advanced HCC patients. Keywords HCC . HAIC . VAS score . Pain . Oxaliplatin . Lidocaine
Introduction Primary hepatocellular carcinoma (HCC) is the fourth leading cause of cancer death in the world [1]. About 25% to 70% of patients were diagonized with advanced liver cancer at the time of diagnosis, and the median survival time of HCC patients is only 4.2 to 7.9 months [2]. The incidence of liver cancer will continue to increase in the next 10 to 20 years, and reach its peak around 2030 [3]. At present, the main treatment for HCC is radical surgical resection, but the recurrence rate after radical resection is still high. Meanwhile, the longterm efficacy of this disease is still not ideal [4]. The
* Wenbo Guo [email protected] 1
Department of Interventional Radiology, the First Affiliated Hospital of Sun Yat-Sen University, No. 58 Zhongshan 2 Road, Guangzhou 510080, China
recurrence rate within 5 years after the radical operation is as high as 60% [5], and about 90% of liver cancer recurrences occur in the liver [6]. From a clinical perspective, tumor diameter, number, and presence or absence of microscopic tumor emboli are currently recognized as major risk
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