Optimal locoregional immunochemotherapy after tumor-mass reduction for advanced hepatocellular carcinoma.
OBJECTIVE
This paper will give a description of our attempts to optimize the locoregional immunochemotherapy for advanced hepatocellular carcinoma.


METHODS
A locoregional immunochemotherapy consisting of continuous recombinant interleukin 2 infusion and intermittent low dose doxorubicin injection was administered to a series of patients.


RESULTS
Seventeen Stage IV HCC patients followed the protocol; 11 received IL-2 infusion for more than 6 months, while 6 patients were suspended within 6 months because of new lesions or side effects from IL-2. After suspending IL-2 infusion patients continued to receive ADR injections. In the former group, excellent direct effect on liver tumors accompanied by increase in peripheral NK activity was observed. During periods of higher NK and LAK activity, direct effects on liver tumors were observed as complete remission (CR) in 4 patients and partial remission (PR) in 2 patients. However, long-term observation of NK activity revealed intractable decrease after the 6th to 8th month despite an increase in IL-2 dose.


CONCLUSIONS
We have shown the clinical usefulness of our locoregional immunochemotherapy after tumor-mass reduction in extending survival periods for advanced HCC patients. However, clinical effects of IL-2 immunotherapy were not observed in all patients. Further clinical and experimental studies are required to obtain longer-lasting enhancement of NK and LAK activity so that patient survival can be improved.
Yamamoto
M
M
First Department of Surgery, Yamanashi Medical University.
Fujii
H
H
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D004333:Drug Administration Routes; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging