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Original ArticleOpen Access
Caffeine Clearance in Patients with Hepatocellular Carcinoma After Transcatheter Oily Chemoembolization Treatment
ThongNgam D 
,
Thumvijit L ,
Tangkijvanich P ,
Janchai A ,
Mahachai V ,
Wittayalertpanya S
,
Thumvijit L ,
Tangkijvanich P ,
Janchai A ,
Mahachai V ,
Wittayalertpanya S Background : Hepatocellular carcinoma (HCC) is a common neoplasm worldwide, parti-
cularly in Asia, with a grave prognosis. Transcatheter Oily Chemoembolization (TOCE) is now
universally accepted as the method of choice for the treatment of inoperable HCC. The purpose of this
study was to evaluate caffeine clearance, a quantitative liver function assessment, in HCC patients
before and after treatment with TOCE.
Method : Both conventional liver function test (LFI') and caffeine clearance were evaluated
in twelve patients. Each patient took a 3.5 mg/kg single oral dose of caffeine solution before TOCE,
1 day and 5 weeks after treatment. Blood samples were subsequently collected at 0.5, 1.5, 3, 5, 10
and 24 hours after each dose of caffeine administration and assayed for serum caffeine level by the
HPLC technique. Clearance (CI) was calculated using the equation of Cl
=
Kel * Vd (Kel
=
elimina-
tion rate constant, Vd
=
volume of distribution) and half-life was determined using pharmacokinetic
analysis.
Results : The mean caffeine clearance 1 day after TOCE (0.51
เธ‘
0.096) and 5 weeks after
TOCE treatment (0.43
เธ‘
0.07) was significantly reduced compared with the mean caffeine clearance
before treatment (0.79 เธ‘ 0.2 ml/min*kg) with the p
=
0.06 and p
=
0.03, respectively. No significant
changes (p
>
0.05) in most conventional LFI' were observed 5 weeks after treatment.
Vol. 85 No. 12
CAFFEINE CLEARANCE IN HCC AFTER TOCE
1281
Conclusions : In the present study, the authors found that caffeine clearance was reduced
after TOCE in patients with HCC inspite of no changes in conventional LFf. Thus, the determina-
tion of caffeine clearance can serve as a useful parameter for the assessment of hepatic functional
reserve in HCC patients post TOCE treatment.
Key word : Caffeine Clearance, Hepatocellular Carcinoma, Chemoembolization
cularly in Asia, with a grave prognosis. Transcatheter Oily Chemoembolization (TOCE) is now
universally accepted as the method of choice for the treatment of inoperable HCC. The purpose of this
study was to evaluate caffeine clearance, a quantitative liver function assessment, in HCC patients
before and after treatment with TOCE.
Method : Both conventional liver function test (LFI') and caffeine clearance were evaluated
in twelve patients. Each patient took a 3.5 mg/kg single oral dose of caffeine solution before TOCE,
1 day and 5 weeks after treatment. Blood samples were subsequently collected at 0.5, 1.5, 3, 5, 10
and 24 hours after each dose of caffeine administration and assayed for serum caffeine level by the
HPLC technique. Clearance (CI) was calculated using the equation of Cl
=
Kel * Vd (Kel
=
elimina-
tion rate constant, Vd
=
volume of distribution) and half-life was determined using pharmacokinetic
analysis.
Results : The mean caffeine clearance 1 day after TOCE (0.51
เธ‘
0.096) and 5 weeks after
TOCE treatment (0.43
เธ‘
0.07) was significantly reduced compared with the mean caffeine clearance
before treatment (0.79 เธ‘ 0.2 ml/min*kg) with the p
=
0.06 and p
=
0.03, respectively. No significant
changes (p
>
0.05) in most conventional LFI' were observed 5 weeks after treatment.
Vol. 85 No. 12
CAFFEINE CLEARANCE IN HCC AFTER TOCE
1281
Conclusions : In the present study, the authors found that caffeine clearance was reduced
after TOCE in patients with HCC inspite of no changes in conventional LFf. Thus, the determina-
tion of caffeine clearance can serve as a useful parameter for the assessment of hepatic functional
reserve in HCC patients post TOCE treatment.
Key word : Caffeine Clearance, Hepatocellular Carcinoma, Chemoembolization
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