title: Successful treatment of pulmonary metastases associated with advanced hepatocellular carcinoma by systemic 5-fluorouracil combined with interferon-alpha in a hemodialysis patient.
abstract: A 54-year-old man maintained on hemodialysis had a relapse of multiple pulmonary metastases after multimodal therapy for primary hepatocellular carcinoma (HCC). He was treated with tegafur-uracil (UFT; 400 mg/day) and interferon alfa (IFN-alpha; 5 x 10(6) units three times per week) for 4 weeks. Following this he was treated with systemic 5-fluorouracil (5-FU; 1000 mg/day, 5 days per week) and cisplatin (CDDP; 10 mg/day, 5 days per week for 2 weeks). The response to the above treatments was inadequate; pulmonary metastasis deteriorated. Finally, we selected systemic chemotherapy of 5-FU (750 mg/day, 5 days per week) and recombinant IFN-alpha-2b (3 x 10(6) units three times per week) for 2 weeks. This therapy resulted in excellent shrinkage of pulmonary metastases, without severe adverse reactions. Hemodialysis was performed three times a week. We report a case of successful treatment of pulmonary metastases by systemic combination chemotherapy of 5-FU-IFN, previously unsuccessfully treated with UFT-IFN and 5-FU-CDDP in a patient on hemodialysis. Further studies are needed to select appropriate drugs with fluoropyrimidine-based systemic chemotherapy, and to analyze the pharmacokinetics of those agents in hemodialysis patients with HCC and extrahepatic metastases.
authors.affiliation: Department of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Katamura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aikata
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kimura
authors.forename: Takahiro
authors.initials: T
authors.lastname: Azakami
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Kawaoka
authors.forename: Shintaro
authors.initials: S
authors.lastname: Takaki
authors.forename: Koji
authors.initials: K
authors.lastname: Waki
authors.forename: Akira
authors.initials: A
authors.lastname: Hiramatsu
authors.forename: Yoshiiku
authors.initials: Y
authors.lastname: Kawakami
authors.forename: Shoichi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama