A new chemotherapeutic regimen for advanced unresectable hepatocellular carcinoma.
OBJECTIVE
The aim of this study was to evaluate the efficacy and toxicity of a novel chemotherapeutic regimen for advanced unresectable hepatocellular carcinoma.


METHODS
Seventeen patients with unresectable hepatocellular carcinoma were treated by arterial infusion once a week of low-dose cisplatin (12 mg/m2) and doxorubicin (6 mg/m2) via a subcutaneously implanted injection port and by daily oral administration of 300 mg/day of UFT comprising 5-fluorouracil prodrug tegafur (FT) and uracil (U) at a ratio of 1:4.


RESULTS
The median number of chemotherapy courses was 13 (range, 5-33). All patients were evaluated for response, toxicity, and survival. As assessed by conventional imaging criteria, there were 3 (17.6%) complete responses with disappearance of the primary tumor, tumor thrombosis of the portal vein and metastatic para-aortic lymph node swelling. In addition, there were 4 (23.5%) partial responses. Among 11 patients who had initially high alpha-fetoprotein levels (> 200 ng/mL), 5 (45%) had a > 50% drop after therapy. The overall tumor response rate (complete response + partial response) was 41% and the median survival was 7.1 (range; 4.2-25.1) months. As for toxicity, there was 1 treatment-related death due to septicemia caused by catheter-related infection. Myelosuppression and renal toxicity was relatively mild and transient.


CONCLUSIONS
These results suggest that our low-dose chemotherapeutic regimen may be useful for the treatment of advanced unresectable hepatocellular carcinoma without worsening the quality of life of the patient.
Third Department of Internal Medicine, Osaka City University Medical School, 1-4-3, Asahimachi, Abenoku, Osaka, 545-8585, Osaka, Japan.
Shuichi
S
Seki
Takao
T
Yamada
Nobuyoshi
N
Kawakita
Hideo
H
Masuichi
Takuya
T
Kitada
Hiroki
H
Sakaguchi
D000284:Administration, Oral; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011859:Radiography; D005641:Tegafur / Q000008:administration & dosage; D016896:Treatment Outcome; D014498:Uracil / Q000008:administration & dosage
D005641:Tegafur; D014498:Uracil; D004317:Doxorubicin; D002945:Cisplatin