title: Efficacy of therapy for advanced hepatocellular carcinoma: intra-arterial 5-fluorouracil and subcutaneous interferon with image-guided radiation.
abstract: OBJECTIVE
  To evaluate the efficacy of intra-arterial 5-fluorouracil (5-FU) and subcutaneous interferon (IFN) combined with image-guided radiation therapy (IGRT) in advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT).
  
  
  METHODS
  Twenty HCC patients with PVTT were treated with 5-FU and IFN combined with image-guided radiation therapy (IGRT) (IGRT group), and as controls, 20 patients with PVTT were treated with 5-FU and IFN alone (non-IGRT group). Overall survival (OS) time, response rates, time to progression (TTP) and safety were compared across groups.
  
  
  RESULTS
  Complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD) of PVTT were 5%, 55%, 40% and 0% in the IGRT group and 0%, 30%, 35% and 35%, in the non-IGRT group, respectively. CR, PR, SD, and PD of the whole tumor were 0%, 35%, 45% and 20% in the IGRT group and 0%, 30%, 35% and 35%, in the non-IGRT group, respectively. Overall median survival was significantly longer in the IGRT group (12.0 months 95% confidence interval [CI], 9.3-17.6 months) than in the non-IGRT group (9.1 months [95% CI, 5.5-11.1 months]) (P = 0.041). TTP was significantly longer in the IGRT group (6.9 months [95% CI, 5.6-10.2 months]) than in the non-IGRT group (4.0 months [95% CI, 3.3-6.4 months]) (P = 0.034).
  
  
  CONCLUSIONS
  The response rates, median OS time and TTP in patients with advanced HCC with PVTT who received this novel combination therapy of intra-arterial 5-FU and subcutaneous IFN with IGRT are encouraging, and this combination therapy warrants further investigation.
authors.affiliation: Department of Gastroenterology and Hematology, Hokkaido University, Sapporo, Japan. mchuuma@med.hokudai.ac.jp
authors.forename: Makoto
authors.initials: M
authors.lastname: Chuma
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Taguchi
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Shinichi
authors.initials: S
authors.lastname: Shimizu
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Nakanishi
authors.forename: Koji
authors.initials: K
authors.lastname: Ogawa
authors.forename: Takuya
authors.initials: T
authors.lastname: Sho
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Horimoto
authors.forename: Tomoe
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Masato
authors.initials: M
authors.lastname: Nakai
authors.forename: Katsumi
authors.initials: K
authors.lastname: Terashita
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Sakuhara
authors.forename: Daisuke
authors.initials: D
authors.lastname: Abo
authors.forename: Yoko
authors.initials: Y
authors.lastname: Tsukuda
authors.forename: Seiji
authors.initials: S
authors.lastname: Tsunematsu
authors.forename: Shuhei
authors.initials: S
authors.lastname: Hige
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Kato
authors.forename: Hiroki
authors.initials: H
authors.lastname: Shirato
authors.forename: Masahiro
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authors.lastname: Asaka
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy; D018450:Disease Progression; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007269:Injections, Intra-Arterial; D007564:Japan / Q000453:epidemiology; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D061089:Radiotherapy, Image-Guided / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D005472:Fluorouracil