title: Intra-arterial chemotherapy followed by chemo-embolisation in unresectable hepatocellular carcinoma.
abstract: Unresectable hepatocellular carcinoma is related to a poor prognosis. Encouraging response rates and survival have been reported with intra-arterial (i.a.) chemotherapy and chemo-embolisation, but limited data are available on the association of the two treatment modalities. We therefore started a new programme combining i.a. chemotherapy with chemo-embolisation. The treatment regimen consisted of L-leucovorin (100 mg/m2 i.v.), 5-fluorouracil (800 mg/m2 i.a.), and carboplatin (250 mg/m2 i.a.). Chemo-embolisation with mitoxantrone (10 mg/m2) plus ethiodized oil followed immediately. The same treatment plus gelatin sponge was given after 28 days. 26 patients entered the study and were evaluable for response and side-effects. Main patient characteristics were: males 21, females 5: median age 68 years (range 42-76 years); stage TNM II-III 17, IVA 9; Child's A 12, Child's B 14; elevated baseline alpha-fetoprotein 17; cirrhosis 25. 14 patients had a partial response (54%; 95% confidence interval 33-73%), 3 had stabilisation and 9 had progressive disease. Median survival was 11 months (range 2-20+). 16 patients had grade I-II pain and 15 grade I-II fever. Our results indicate that the regimen is safe, well tolerated and capable of inducing objective remissions in a high percentage of patients with hepatocellular carcinoma.
authors.affiliation: Division of Medical Oncology, City Hospital, Veneto, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Colleoni
authors.forename: G
authors.initials: G
authors.lastname: Liessi
authors.forename: G
authors.initials: G
authors.lastname: Mastrapasqua
authors.forename: P
authors.initials: P
authors.lastname: Nelli
authors.forename: G
authors.initials: G
authors.lastname: Vicario
authors.forename: G
authors.initials: G
authors.lastname: Sgarbossa
authors.forename: F
authors.initials: F
authors.lastname: Pancheri
authors.forename: P
authors.initials: P
authors.lastname: Manente
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D015996:Survival Rate
chemical_list: D016190:Carboplatin; D008942:Mitoxantrone; D005472:Fluorouracil