title: Combined transarterial targeting locoregional immunotherapy-chemotherapy for patients with unresectable hepatocellular carcinoma: a new alternative for an old problem.
abstract: The prognosis for patients with advanced (stage III and IV) hepatocellular carcinoma (HCC) remains poor. Liver resection and liver transplantation have limited effects on overall survival. Our study was carried out to assess a novel therapeutic approach, which includes transarterial locoregional chemotherapy and in vivo locoregional dual immunostimulation, in patients with unresectable HCC. A group of 20 patients with stage III and IV hepatocellular carcinoma had 10 courses (once per day) of transarterial targeted locoregional immunotherapy with interferon-gamma (IFN-gamma) and interleukin-2 (IL-2), emulsified in a Lipiodol-Urografin mixture. The target organs were the spleen and the liver tumor itself. One course of intrahepatic locoregional targeting transarterial chemotherapy was given 10 days after completion of immunotherapy (mitomycin C, carboplatin, Farmorubicin, Leucovorin, 5-fluorouracil, and IFN-gamma). This was followed after 2 months by another course of transarterial targeted locoregional immunotherapy-chemotherapy. All patients survived the operation and had a mean survival time of 18 months (4-22 months). There was a decrease in the tumor size of 14 of the 20 patients. Serum alpha-fetoprotein (AFP) levels declined in 14 patients, reaching normal levels in 12 patients. These preliminary results indicate that combined locoregional immunotherapy-chemotherapy is a promising therapeutic approach in patients suffering from advanced nonresectable HCC and merits further evaluation.
authors.affiliation: Department of Hepatobiliary-Pancreatic Surgery, St. Savas Hospital, Athens, Greece.
authors.forename: N J
authors.initials: NJ
authors.lastname: Lygidakis
authors.forename: P
authors.initials: P
authors.lastname: Kosmidis
authors.forename: N
authors.initials: N
authors.lastname: Ziras
authors.forename: J
authors.initials: J
authors.lastname: Parissis
authors.forename: E
authors.initials: E
authors.lastname: Kyparidou
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000379:methods; D007371:Interferon-gamma / Q000008:administration & dosage / Q000627:therapeutic use*; D007376:Interleukin-2 / Q000008:administration & dosage / Q000627:therapeutic use*; D002955:Leucovorin / Q000008:administration & dosage; D008099:Liver / Q000000981:diagnostic imaging / Q000187:drug effects / Q000276:immunology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009336:Necrosis; D010865:Pilot Projects; D013154:Spleen / Q000000981:diagnostic imaging / Q000187:drug effects / Q000276:immunology; D015996:Survival Rate; D014055:Tomography, Emission-Computed; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D007376:Interleukin-2; D000509:alpha-Fetoproteins; D015251:Epirubicin; D016685:Mitomycin; D007371:Interferon-gamma; D016190:Carboplatin; D002955:Leucovorin; D005472:Fluorouracil