Chemoembolization with cisplatin, lipiodol and Gelfoam and subsequent systemic chemotherapy with cisplatin and interferon in patients with hepatocellular carcinoma: a non-randomized prospective study.
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.
Baur
Martina
M
Ludwig Boltzmann Institute for Applied Cancer Research (LBI-ACR VIEnna), 3rd Medical Department of Oncology, Kaiser Franz Josef-Spital, Kundratstrasse 3, 1100-Vienna, Austria.
Walter
Reinhard
R
Gebauer
Axel
A
Tscholakoff
Dimiter
D
Lochs
Herbert
H
Mühlbacher
Ferdinand
F
Turetschek
Karl
K
Binder
Reinhard
R
Hudec
Marcus
M
Gangl
Alfred
A
Ferenci
Peter
P
Dittrich
Christian
C
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
D003287:Contrast Media; D006490:Hemostatics; D007459:Iodized Oil; D002945:Cisplatin