Abstract: Objective:This study aims to analyze the risk factors for severe abdominal pain in patients with liver malignant tumors treated with FOLFOX regimen hepatic arterial infusion chemotherapy (HAIC) in order to optimize the treatment plan and improve treatment tolerance.
Methods:This study retrospectively analyzed the data of 217 patients with primary and secondary liver malignancy who received FOLFOX-HAIC treatment at the Department of Imaging Medicine, Inner Mongolia People's Hospital, from January 2021 to December 2024. A total of 33 patients who experienced abdominal pain during HAIC pump medication and within 24 hours after medication cessation were analyzed. These patients were categorized into a severe abdominal pain group and a mild abdominal pain group based on visual analog scale (VAS) scores. Univariate and multivariate Logistic regression analyses were conducted to identify factors contributing to severe abdominal pain. Additionally, a Kendall correlation analysis was performed to examine the relationship between VAS scores in the severe pain group and the diameter of the catheterized artery.
Results:Of these 33 patients, 16 experienced severe abdominal pain （VAS≥7), and 17 experienced mild-to-moderate abdominal pain (VAS < 7). Baseline characteristics were comparable between the two groups, with no statistically significant differences (all P>0.05), except for the total dose of oxaliplatin and the diameters of the common hepatic artery, proper hepatic artery, and catheterized artery. Univariate logistic analysis identified age, diameters of the common hepatic artery, proper hepatic artery, and catheterized artery, as well as the total dose of oxaliplatin, as factors associated with severe abdominal pain (all P<0.05). Multivariate logistic analysis revealed that the diameter of the catheterized artery was an independent risk factor for severe abdominal pain (P<0.05). Further analysis of the correlation between VAS scores and catheterized artery diameter in the severe abdominal pain group demonstrated a significant negative correlation (r= -0.535, P<0.05).
Conclusions:This study shows that the diameter of the catheterized artery is an independent risk factor for the occurrence of severe abdominal pain after FOLFOX-HAIC treatment. Smaller artery diameter may lead to local ischemia, thereby causing severe abdominal pain.

Key words: Liver malignancy, Interventional therapy, FOLFOX regimen, Abdominal pain, Analysis of risk factors