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

Abstract

AIM:To investigate the poor prognosis of HCC with PVTT, we evaluated the efficacy by a new combination chemotherapy for advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT). M E T H O D S :F r o m 2 0 0 2 t o 2 0 0 7, a t o t a l o f 1 0 consecutive patients with Stage IVA HCC accompanied by PVTT were studied prospectively to examine the efficacy of treatment by intra-arterial infusion of a chemotherapeutic agents consisting of etoposide, carboplatin, epirubicin and pharmacokinetic modulating chemotherapy by 5-FU and enteric-coated tegafur/uracil. RESULTS:The mean course of chemotherapy was 14.4 (range, 9-21) mo. One patient showed complete response (CR) with disappearance of HCC and PVTT after treatment, and the two patients showed partial response (PR), response rate (CR + PR/All cases 30%). The median survival time after the therapy was 457.2 d. The one-year survival rate was 70%. Adverse reactions were tolerable. CONCLUSION:Although the prognosis of most patients with Stage IVA HCC by PVTT is poor, our combination chemotherapy may induces long-term survival and is an effective treatment and produced anti-tumor activity with tolerable adverse effects in patients for advanced Stage IVA HCC accompanied by PVTT.

Long-term clinical outcomes of hepatic arterial infusion chemotherapy with cisplatin with or without 5-fluorouracil in locally advanced hepatocellular carcinoma

“…To the best of our knowledge, however, there is no consensus regarding the most useful chemotherapeutic agents, dosage, and optimal administration schedules with HAIC. Various chemotherapeutic agents for HAIC have been tried individually or in combination, with 5-fluorouracil (5-FU) and cisplatin being most commonly used (Ishikawa et al 2007;Woo et al 2010;Yoshikawa et al 2008). However, those studies were based upon small study populations, heterogeneous clinical background, the shorter follow-up duration, and the different administration protocols (mostly protracted infusion of low-doses of drugs) (Ando et al 2002;Ikeda et al 2007;Ishikawa et al 2007).…”

Secondary prevention of recurrence by interferon therapy after ablation therapy for hepatocellular carcinoma in chronic hepatitis C patients

“…In patients with advanced HCC or extrahepatic metastasis, chemotherapy is mostly performed and its usefulness has been shown [1][2][3][4][5] . However, in patients with stageⅠor Ⅱ HCC, including early-stage HCC, percutaneous therapy is useful because its impact on normal hepatocytes is relatively small.…”

A randomized study of cisplatin and 5-FU hepatic arterial infusion chemotherapy with or without adriamycin for advanced hepatocellular carcinoma

“…Various chemotherapeutic agents have been tried individually or in combination for HAIC treatment of HCC, with 5-fluorouracil (5-FU, a thymidylate synthase inhibitor) and cisplatin (a DNA cross-linking compound) being most commonly used [6,7]. Previously, our study showed that treatment response in high-dose CF-HAIC was significantly better than that in low-dose HAIC.…”