title: The effects of hepatic artery chemotherapy on viral hepatitis in patients with hepatocellular carcinoma.
abstract: Transcatheter arterial chemoembolization (TACE) or arterial Yttrium-90 (90Y) microspheres are used to treat unresectable hepatocellular carcinoma (HCC), but little is known about their effects on viral hepatitis. The aim of this study was to determine their effect on viral hepatitis in patients with HCC. We carried out a retrospective review of patients treated for HCC. Worsening of viral hepatitis was determined by serum chemistry and viral loads where available. Fifty-two patients treated with TACE were followed for a mean of 22.0 months. Thirty-nine patients (75%) had decreased/stable tumor. Two of the 39 (5%) patients with decreased/stable tumor burden had a sustained increase in bilirubin. None had a sustained ALT elevation or significant increase in viral load after TACE. Twenty-four patients treated with 90Y microspheres were followed for a mean of 12.0 months. Twenty-two of these had a decreased/stable tumor burden and no patient had a significant elevation of ALT. However, 7 of the 22 had a sustained bilirubin elevation. We conclude that neither TACE nor 90Y treatment was associated with worsening viral hepatitis in this group of HCC patients. The presence of chronic viral hepatitis with normal bilirubin should not exclude the use of these therapies in patients with unresectable HCC.
authors.affiliation: Liver Cancer Center, Starzl Transplant Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
authors.forename: Jawad
authors.initials: J
authors.lastname: Ahmad
authors.forename: John
authors.initials: J
authors.lastname: Rhee
authors.forename: Brian I
authors.initials: BI
authors.lastname: Carr
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000150:complications*; D016461:Chemoembolization, Therapeutic; D005260:Female; D006499:Hepatic Artery; D006509:Hepatitis B / Q000150:complications / Q000628:therapy*; D006526:Hepatitis C / Q000150:complications / Q000628:therapy*; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D012189:Retrospective Studies; D019562:Viral Load; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
chemical_list: D015021:Yttrium Radioisotopes
references.citation: Hepatogastroenterology. 1996 May-Jun;43(9):681-7
references.pmid: 8799415
references.citation: Gastroenterology. 1991 Jan;100(1):182-8
references.pmid: 1983820
references.citation: J Hepatol. 1990 Sep;11(2):181-4
references.pmid: 2174933
references.citation: Oncology (Williston Park). 1994 Apr;8(4):77-84; discussion 84, 89-90 passim
references.pmid: 8003400
references.citation: Cancer Chemother Pharmacol. 1994;33 Suppl:S89-92
references.pmid: 8137491
references.citation: Hepatogastroenterology. 2002 Jan-Feb;49(43):79-86
references.pmid: 11941989
references.citation: Q J Med. 1989 Oct;73(270):911-7
references.pmid: 2629023
references.citation: Lancet. 1975 Sep 20;2(7934):528-30
references.pmid: 51345
references.citation: J Clin Oncol. 2002 Nov 15;20(22):4459-65
references.pmid: 12431969
references.citation: Cancer. 1996 Nov 15;78(10 ):2210-5
references.pmid: 8918416
references.citation: Arch Intern Med. 1985 Jul;145(7):1313-4
references.pmid: 4015284
references.citation: J Med Virol. 2000 Nov;62(3):299-307
references.pmid: 11055239
references.citation: Liver Transpl. 2004 Feb;10(2 Suppl 1):S107-10
references.pmid: 14762849
references.citation: Ann Intern Med. 1982 Apr;96(4):447-9
references.pmid: 7065560
references.citation: Hepatology. 1998 Jun;27(6):1578-83
references.pmid: 9620330
references.citation: Lancet. 1996 Jan 13;347(8994):92-3
references.pmid: 8538348
references.citation: Radiology. 1983 Aug;148(2):397-401
references.pmid: 6306721
references.citation: Arch Intern Med. 2000 Nov 27;160(21):3227-30
references.pmid: 11088082
references.citation: Ann Oncol. 1994 Nov;5(9):861-2
references.pmid: 7848891
references.citation: J Clin Oncol. 2004 Mar 1;22(5):927-34
references.pmid: 14990649
references.citation: Ann Surg. 1994 Mar;219(3):236-47
references.pmid: 8147605
references.citation: N Engl J Med. 1995 May 11;332(19):1256-61
references.pmid: 7708069
references.citation: J Vasc Interv Radiol. 1996 May-Jun;7(3):419-25
references.pmid: 8761824
references.citation: Cancer. 1998 Sep 15;83(6):1224-30
references.pmid: 9740089
references.citation: Lancet. 2002 May 18;359(9319):1734-9
references.pmid: 12049862
references.citation: J Vasc Interv Radiol. 1999 Jun;10(6):793-8
references.pmid: 10392950
references.citation: Q J Med. 1989 Oct;73(270):895-902
references.pmid: 2629021