Arterial infusion chemotherapy for advanced hepatocellular carcinoma using EPF and EAP therapies

Abstract

Arterial infusion chemotherapy of EPF (etoposide, cisplatin, and 5-fluorouracil) or EAP (etoposide, Adriamycin, and cisplatin) was carried out in 28 cases of advanced hepatocellular carcinoma (HCC) between January 1988 and December 1990, and assessment was made of the anticancer efficacy of each treatment method. In all, 13 patients were treated with EPF therapy and 15 received EAP therapy. The anticancer agents were infused through a catheter inserted into the proper or common hepatic artery. The catheter was inserted via the axillary artery or common femoral artery using Seldinger's method or the cut-down method. The results of each therapy were analyzed in relation to the tumor regression rate and the side effects encountered. The tumor regression rate was determined on the basis of two-dimensional evidence obtained by computed tomography performed before and after treatment. The treatment results were also compared with the results of chemoembolization therapy using a mixture of cisplatin (CDDP), Adriamycin (ADM) and lipiodol. Of the 28 patients treated with arterial infusion chemotherapy, 14 (50%) attained a regression rate of 50% (PR). In all, 46% of the EPF group and 53% of the EAP group achieved a PR. These results were superior to those obtained using chemoembolization therapy. In general, the side effects were relatively mild and transient.

Phase I/II Study of Sorafenib in Combination with Hepatic Arterial Infusion Chemotherapy Using Low-Dose Cisplatin and 5-Fluorouracil

“…In a prior study, the response rate (RR) of agents used for HAIC including cisplatin (CDDP) monotherapy and epirubicin hydrochloride monotherapy was 37% [17] and 15.1%, respectively [18]. Combination chemotherapy, such as CDDP with 5-fluorouracil (5-FU) and etoposide with CDDP and 5-FU, have achieved a RR of between 14-44% [19][20][21][22][23][24][25] and 46% [26], respectively. Sorafenib (Nexavar ® , Bayer HealthCare Pharmaceuticals) is a small molecule that inhibits the proliferation of cancer cells and tumor angiogenesis.…”

Improved survival for hepatocellular carcinoma with portal vein tumor thrombosis treated by intra-arterial chemotherapy combining etoposide, carboplatin, epirubicin and pharmacokinetic modulating chemotherapy by 5-FU and enteric-coated tegafur/uracil: A pilot study

“…We selected etoposide, carboplatin, epirubicin and pharmacokinetic modulating chemotherapy by 5-FU and enteric-coated tegafur/uracil. Firstly, etoposide is agent which has shown significant antitumor against HCC [14][15][16] . It could be suggested as part of intensive multidrug regimens for HCC and highrisk HBV [17][18][19] .…”

Percutaneous Transfemoral Hepatic Arterial Infusion Catheter Placement with the Use of a Downsized Coaxial Catheter System: Technical Feasibility Study

“…With respect to catheter placement methods that involve femoral access, there have been many reports of catheter insertion procedures involving the cutdown method by exposing the femoral artery itself (6) and interventional methods with or without an introducer sheath (3,4,(7)(8)(9)(10). In our institution, we usually puncture the femoral artery directly without the use of a vascular sheath (ie, sheathless method) (3,4,(7)(8)(9).…”