Radioimmunotherapy in the multimodality treatment of hepatocellular carcinoma with reference to second-look resection.
Experimental study using nude mice human hepatocellular carcinoma (HCC) xenograft indicated that the combination treatment with iodine 131 (131I)-anti-human HCC isoferritin (131I-isoFtAb), cisplatin, and mixed bacterial vaccine (MBV) yielded better inhibition rate as compared with double combination or 131I-isoFtAb alone. Based on these findings, 25 patients with surgically proven nonresectable and pathologically proven HCC have been treated by radioimmunotherapy using 131I-isoFtAb intrahepatic arterial infusion as a part of multimodality treatment. Of the 25 patients, seven (28.0%) received second-look resection after marked shrinkage of tumor. The 1-year survival was 52.5% (12/23) and 2-year survival 27.7% (five of 18) in the entire series. Of the five patients with 2-year survival, four were in the second-look resection group. Patients with tumor less than or equal to 8 cm showed higher second-look resection rate (62.5% versus 11.8%) and 1-year survival (85.7% versus 37.5%) as compared with tumor greater than 8 cm. Mixed bacterial vaccine as adjuvant immunotherapy seemed effective to prolong survival. The 2-year survival was higher in patients with second-look resection as compared with those without (75.0% versus 14.3%). Thus, radioimmunotherapy using 131I-isoFtAb might be one of the modalities of choice, particularly in the conversion of nonresectable to resectable HCC in a well-designed multimodality treatment regimen.
Tang
Z Y
ZY
Liver Cancer Institute, Shanghai Medical University, People's Republic of China.
Liu
K D
KD
Bao
Y M
YM
Lu
J Z
JZ
Yu
Y Q
YQ
Ma
Z C
ZC
Zhou
X D
XD
Yang
R
R
Gan
Y H
YH
Lin
Z Y
ZY
D000818:Animals; D000906:Antibodies / Q000627:therapeutic use; D001428:Bacterial Vaccines / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000532:radiotherapy / Q000628:therapy*; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005293:Ferritins / Q000276:immunology; D006801:Humans; D007167:Immunotherapy; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000628:therapy*; D051379:Mice; D008819:Mice, Nude; D012086:Reoperation; D016019:Survival Analysis; D000509:alpha-Fetoproteins / Q000378:metabolism
D000906:Antibodies; D001428:Bacterial Vaccines; D007457:Iodine Radioisotopes; D000509:alpha-Fetoproteins; D005293:Ferritins; D002945:Cisplatin