Caffeine Clearance in Patients with Hepatocellular Carci noma after Transcatheter Oily Chemoembolization Treat ment
DUANGPORN THONG-NGAM, M.D.*, LAKHANA THUMVUIT, M.Sc.**, PISIT T ANGKUVA NICH, M.D.***, AKKAWAT JANCHAI, M.D.****, VAROCHA MAHACHAI, M.D.*****, SUPEECHA WITTA Y ALERTPANYA, M.Sc. **
Affiliation : * Department of Physiology, ** Department of Pharmacology, *** Department of Biochemistry, **** Department of Radiology, ***** Gastroenterology Unit, Department of Medicine, Faculty of Medicine, Chulalongkom University, Bangkok 10330, Thailand.
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 ± 0.096) and 5 weeks after TOCE treatment (0.43 ± 0.07) was significantly reduced compared with the mean caffeine clearance = = before treatment (0.79 ± 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.
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.
Keywords : Caffeine Clearance, Hepatocellular Carcinoma, Chemoembolization
