title: [Efficacy of hepatic arterial infusion therapy for advanced hepatocellular carcinoma using 5-fluorouracil, epirubicin and mitomycin-C].
abstract: OBJECTIVE
  Prognosis of advanced hepatocellular carcinoma (HCC) treated by conventional therapies has been considered to be poor. The aim of this study was to evaluate the efficacy of hepatic arterial infusion therapy (HAIT) using FEM (5-fluorouracil, epirubicin, mitomycin-C) regimen for advanced HCC.
  
  
  METHODS
  Eighteen patients received repeated HAIT using an implanted drug delivery system. Of the 18 patients, 8 patients had HCC with portal vein tumor thrombosis, 9 patients had recurrent HCC after transarterial chemoembolization (TACE) and 1 patient after surgical resection. The patients received 5-fluorouracil (330 mg/m(2), every week), epirubicin (30 mg/m(2), every 4 weeks) and mitomycin-C (2.7 mg/m(2), every 2 weeks).
  
  
  RESULTS
  Mean age was 51 years. The response rate (complete response+partial response) by tumor size on abdominal CT was 38.9%. Survival ranged from 2 to 24 months and the median survival time was 8 months. The cumulative survival rate of responders group was significantly higher than non-responders group (p=0.0385). The mean levels of serum alpha-FP and PIVKA-II in responders group decreased after HAIT (3,179 ng/mL and 2,850 ng/mL) than before (11,218 ng/mL and 4,396 ng/mL), but not significantly. Chemotherapy-related side effects were nausea, vomiting and alopecia. Three patients had catheter-related complications. One patient developed gastric ulcer.
  
  
  CONCLUSIONS
  HAIT using FEM regimen is a useful therapeutic option for patients with advanced HCC with portal vein tumor thrombosis or ineffective response to other therapies.
authors.affiliation: Departments of Internal Medicine, University of Keimyung College of Medicine, Dongsan Medical Center, Daegu, Korea.
authors.forename: Jun Young
authors.initials: JY
authors.lastname: Hwang
authors.forename: Byoung Kuk
authors.initials: BK
authors.lastname: Jang
authors.forename: Ki Min
authors.initials: KM
authors.lastname: Kwon
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Chung
authors.forename: Kyung Sik
authors.initials: KS
authors.lastname: Park
authors.forename: Kwang Bum
authors.initials: KB
authors.lastname: Cho
authors.forename: Jae Seok
authors.initials: JS
authors.lastname: Hwang
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Ahn
authors.forename: Gab Chul
authors.initials: GC
authors.lastname: Kim
authors.forename: Young Hwan
authors.initials: YH
authors.lastname: Kim
authors.forename: Jin Soo
authors.initials: JS
authors.lastname: Choi
authors.forename: Jung Hyeok
authors.initials: JH
authors.lastname: Kwon
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D015918:Infusion Pumps, Implantable; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D015996:Survival Rate
chemical_list: D015251:Epirubicin; D016685:Mitomycin; D005472:Fluorouracil