Treatment of hepatocellular carcinoma (HCC) with systemic chemotherapy combining epirubicin, cisplatinum and infusional 5-fluorouracil (ECF regimen).
OBJECTIVE
We tested the efficacy of a systemic chemotherapy regimen combining epirubicin, cisplatinum and infusional 5-fluorouracil (ECF) in a cohort of patients with hepatocellular carcinoma (HCC) who could not be given surgical, intraarterial or percutaneous treatment.


METHODS
Between January 1998 and June 2000, 21 patients with metastatic and/or locally advanced HCC complicating a fibrous liver or a well-compensated (Child A) cirrhosis were given systemic chemotherapy with the ECF regimen. Tumor responses as assessed on CT scan and in terms of survival were studied.


RESULTS
Patients completed a median of five chemotherapy courses. Overall tolerance was good but eight patients developed grade 3-4 toxicity, mainly hematological, and one patient experienced a grade 4 renal toxicity. Median survival was 10 months. Actuarial survivals (+/-SD) at 6 months, 1 year and 2 years were 90.2+/-9%, 70.3+/-10% and 24.6+/-19%, respectively. Of the 21 patients, 13 died, 12 from their tumor and 1 from treatment-related renal failure. There were only three objective responses (14.5%; CI95 1-28%) but one of these corresponded to a pathological complete response. The delay to tumor progression was 5.9+/-4.7 months.


CONCLUSIONS
Systemic chemotherapy using the ECF regimen gave a poor response and low survival rates. It would appear reasonable to pursue the search for potentially efficacious chemotherapy protocols using other drug combinations.
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy*; D002945:Cisplatin / Q000627:therapeutic use*; D015331:Cohort Studies; D004334:Drug Administration Schedule; D015251:Epirubicin / Q000627:therapeutic use*; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D016896:Treatment Outcome
D015251:Epirubicin; D002945:Cisplatin; D005472:Fluorouracil