title: Combination treatment with intrahepatic arterial infusion and intratumoral injection chemotherapy in patients with far-advanced hepatocellular carcinoma and arterioportal or arteriovenous shunts: preliminary results.
abstract: OBJECTIVE
  Combination treatment consisting of hepatic arterial infusion chemotherapy with epirubicin and cisplatin (HAIC-EC) and systemic infusion of low-dose 5-fluorouracil (5-FU) are sometimes effective against advanced hepatocellular carcinoma (HCC). However, there is no effective treatment for advanced HCCs with arterioportal shunts (APS) or arteriovenous shunts (AVS).
  
  
  METHODS
  We investigated a response and adverse events of a new combination protocol of repeated HAIC-EC and percutaneous intratumoral injection chemotherapy with a mixture of recombinant interferon-gamma (IFN-γ) and 5-FU (PIC-IF) in patients with far-advanced HCCs with large APSs or AVSs.
  
  
  RESULTS
  There was a complete response (CR) for the large vascular shunts in all three patients and for all tumor burdens in two patients. Significant side effects were flu-like symptoms (grade 2) and bone marrow suppression (grade 2 or 3) after each cycle, but these were well-tolerated.
  
  
  CONCLUSIONS
  These results suggest that the combination of HAIC-EC and PIC-IF is a new and promising approach for advanced HCC accompanied by a large APS or AVS.
authors.affiliation: Hepatology Center, Bundang Jesaeng General Hospital, Seongnam, Korea.
authors.forename: Ja Seon
authors.initials: JS
authors.lastname: Kim
authors.forename: Young Min
authors.initials: YM
authors.lastname: Park
authors.forename: Nha Young
authors.initials: NY
authors.lastname: Kim
authors.forename: Han Kyeol
authors.initials: HK
authors.lastname: Yun
authors.forename: Ki Jong
authors.initials: KJ
authors.lastname: Lee
authors.forename: Bo Hyun
authors.initials: BH
authors.lastname: Kim
authors.forename: Sang Jong
authors.initials: SJ
authors.lastname: Park
authors.forename: Jae Woo
authors.initials: JW
authors.lastname: Yeon
authors.forename: Guhung
authors.initials: G
authors.lastname: Jung
mesh_terms: D000368:Aged; D000792:Angiography; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005472:Fluorouracil / Q000008:administration & dosage; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D007273:Injections, Intramuscular; D007371:Interferon-gamma / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D011994:Recombinant Proteins; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden
chemical_list: D011994:Recombinant Proteins; D015251:Epirubicin; D007371:Interferon-gamma; D002945:Cisplatin; D005472:Fluorouracil