Efficacy of chemoembolization for hepatocellular carcinomas: experience from the Gustave Roussy Institute and the Bicêtre Hospital.
Chemoembolization (CE) has been used for more than 10 years to treat hepatocellular carcinoma (HCC) in our departments, and three studies have been done. The first was a retrospective study on 232 patients in which CE was performed with doxorubicin and Gelfoam with or without Lipiodol; the response rate was 41% (34.7-47.3%) and survival was better for Okuda stage I disease than for stages II and III (2-year survival 82, 29, and 0% respectively); for patients with Lipiodol retention the response rate was over 50%. The second study compared CE with doxorubicin and Gelfoam to symptomatic treatment in a randomized manner; it included 42 patients and failed to demonstrate a survival advantage (1-year survival: CE 24% vs. control 31%; NS). The third study is ongoing and tests CE with cis-platinum, Lipiodol, and Gelfoam. According to our experience prospective randomized studies are warranted to define clearly the best indications for CE in HCC.
Rougier
P
P
Service of Gastroenterology, Gustave Roussy Institute, Villejuif, France.
Roche
A
A
Pelletier
G
G
Ducreux
M
M
Pignon
J P
JP
Etienne
J P
JP
D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005602:France / Q000453:epidemiology; D005781:Gelatin Sponge, Absorbable / Q000008:administration & dosage; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D015996:Survival Rate; D013629:Tamoxifen / Q000627:therapeutic use
D013629:Tamoxifen; D007459:Iodized Oil; D004317:Doxorubicin; D002945:Cisplatin