title: Influence of etiology on host immunity in liver cirrhosis patients with advanced hepatocellular carcinoma receiving intra-arterial chemotherapy.
abstract: OBJECTIVE
  We have shown that continuous intra-arterial combination chemotherapy (IACC) might be more effective for advanced HCC (aHCC) in patients with HCV-related (C-LC) or alcoholic (A-LC) liver cirrhosis (LC) patients than in patients with HBV-related LC (B-LC). This study retrospectively assesses the difference of etiology on host immunity in LC patients with aHCC treated by IACC.
  
  
  METHODS
  Forty-seven adult LC patients with aHCC were treated by IACC between 2005 and 2008, with inoperable tumors according to CT findings. IACC (LV at 12 mg/hr, CDDP at 10 mg/hr, and 5-FU at 250 mg/22 hr) was delivered via the proper hepatic artery every 5 days for 4 weeks using a catheter connected to a subcutaneously implanted drug delivery system. The control group comprised 13 healthy volunteers.
  
  
  RESULTS
  Twelve of the 47 patients with aHCC had B-LC, 27 had C-LC, and 8 had A-LC. In the B-LC group, 1 out of 12 patients had a Japan Integrated Staging (JIS) score of 2, 4 had a JIS score of 3, 7 had a JIS score of 4, and no patients had a JIS score of 5, while the respective numbers were 6, 9, 10 and 2 in the C-LC group, and 1, 1, 5 and 1 in the A-LC group. The response rates were 37.0%, 37.5% and 8.3% in the C-LC, A-LC and B-LC group, respectively. In the C-LC group, the percentage of Th1 cells before and after chemotherapy was significantly higher than in the control group. In the B-LC group, the percentage of Th2 cells after chemotherapy was significantly higher than that in the control group. However, there were no significant differences of Th1 and Th2 cells between the A-LC group and the control group.
  
  
  CONCLUSIONS
  These results indicate that IACC was more effective for aHCC in A-LC patients with normal Th1/Th2 balance and in C-LC patients without Th2 dominance than in B-LC patients who showed Th2 dominance after chemotherapy.
authors.forename: Hidenari
authors.initials: H
authors.lastname: Nagai
authors.forename: Takanori
authors.initials: T
authors.lastname: Mukozu
authors.forename: Takenori
authors.initials: T
authors.lastname: Kanekawa
authors.forename: Teppei
authors.initials: T
authors.lastname: Matsui
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kanayama
authors.forename: Noritaka
authors.initials: N
authors.lastname: Wakui
authors.forename: Kouichi
authors.initials: K
authors.lastname: Momiyama
authors.forename: Koji
authors.initials: K
authors.lastname: Ishii
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Igarashi
authors.forename: Yasukiyo
authors.initials: Y
authors.lastname: Sumino
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology*; D016022:Case-Control Studies; D002945:Cisplatin / Q000008:administration & dosage; D004338:Drug Combinations; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D002955:Leucovorin / Q000008:administration & dosage; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology*; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D004338:Drug Combinations; D017239:Paclitaxel; D002945:Cisplatin; D002955:Leucovorin; D005472:Fluorouracil