title: Chemoembolization with cisplatin, lipiodol and Gelfoam and subsequent systemic chemotherapy with cisplatin and interferon in patients with hepatocellular carcinoma: a non-randomized prospective study.
abstract: Arterial chemoembolization with subsequent systemic chemotherapy was assessed prospectively. Of 94 consecutive patients with HCC, 31 patients were considered to have inoperable disease and were selected for chemoembolization. Twenty-two of the 31 patients underwent chemoembolization. In eight patients, technical problems with catheterization prevented the application of therapy, and one patient rejected further treatment. Regimen: Three monthly cycles of chemoembolization with cisplatin 20 mg/m(2) mixed with lipiodol delivered intraarterially with Gelfoam or collagen on day 1, followed by intravenous chemotherapy with cisplatin 60 mg/m(2) on day 2; interferon alpha-2c 30 microg (10 M IU) subcutaneously on days 2, 5, 9, and 12. Three percent of the patients (1/31) (CI 95% 0.08; 16.7) experienced a partial clinical response, in 53% alpha-fetoprotein levels decreased by more than 50%. On univariate analysis, performance status, Child score, Okuda stage, albumin levels, and lactate dehydrogenase were found to have an effect on survival. Postchemoembolization syndrome occurred in 68% of the patients, nausea/vomiting grades 3/4 (according to the World Health Organization WHO) in six patients, anemia grade 3 in three patients, leukopenia grade 3 in one patient and thrombocytopenia grade 3 in one patient. This treatment regimen is a very selective procedure. Because of the low response rate it is not recommended for routine clinical use.
authors.affiliation: Ludwig Boltzmann Institute for Applied Cancer Research (LBI-ACR VIEnna), 3rd Medical Department of Oncology, Kaiser Franz Josef-Spital, Kundratstrasse 3, 1100-Vienna, Austria.
authors.forename: Martina
authors.initials: M
authors.lastname: Baur
authors.forename: Reinhard
authors.initials: R
authors.lastname: Walter
authors.forename: Axel
authors.initials: A
authors.lastname: Gebauer
authors.forename: Dimiter
authors.initials: D
authors.lastname: Tscholakoff
authors.forename: Herbert
authors.initials: H
authors.lastname: Lochs
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Mühlbacher
authors.forename: Karl
authors.initials: K
authors.lastname: Turetschek
authors.forename: Reinhard
authors.initials: R
authors.lastname: Binder
authors.forename: Marcus
authors.initials: M
authors.lastname: Hudec
authors.forename: Alfred
authors.initials: A
authors.lastname: Gangl
authors.forename: Peter
authors.initials: P
authors.lastname: Ferenci
authors.forename: Christian
authors.initials: C
authors.lastname: Dittrich
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D002945:Cisplatin / Q000008:administration & dosage*; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D005781:Gelatin Sponge, Absorbable / Q000008:administration & dosage*; D006490:Hemostatics / Q000008:administration & dosage; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage*; D008113:Liver Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D006490:Hemostatics; D007459:Iodized Oil; D002945:Cisplatin