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Transcatheter arterial chemoembolization therapy using iodized oil for patients with unresectable hepatocellular carcinoma
Author(s) -
Ueno Kazuto,
Miyazono Nobuaki,
Inoue Hiroki,
Nishida Hirotoshi,
Kanetsuki Ichiro,
Nakajo Masayuki
Publication year - 2000
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(20000401)88:7<1574::aid-cncr11>3.0.co;2-8
Subject(s) - medicine , pirarubicin , gastroenterology , hepatocellular carcinoma , survival rate , mitomycin c , transcatheter arterial chemoembolization , chemotherapy , population , cisplatin , surgery , environmental health
BACKGROUND The current study was conducted to evaluate retrospectively the effects of three kinds of regimens used in transcatheter arterial chemoembolization (TACE) in patients with unresectable hepatocellular carcinoma (HCC) and patients' prognosis, and to analyze their prognostic factors. METHODS The study population was comprised of 152 patients who were treated by TACE alone. Three kinds of regimens were used successively: doxorubicin hydrochloride (ADM) and mitomycin C mixed with iodized oil in 26 patients (ADMOS group), a combination of cisplatin (CDDP) solution and ADMOS in 70 patients (CDDP‐ADMOS group), and CDDP powder and pirarubicin hydrochloride mixed with iodized oil in 56 patients (CTLS group). The CTLS group was comprised of patients with significantly worse background factors than the other two groups. RESULTS The initial tumor response rate with a > 50% reduction was 12%, 23%, and 30%, respectively, in the ADMOS, CDDP‐ADMOS, and CTLS groups. CTLS was significantly more effective than ADMOS ( P < 0.05), and slightly but not significantly better than CDDP‐ADMOS ( P <0.1). The cumulative survival rates for the ADMOS, CDDP‐ADMOS, and CTLS groups were 59.0%, 70.1%, and 72.0%, respectively, at 1 year; 0%, 16.3%, and 29.8%, respectively, at 3 years; and 0%, 4.1%, and 16.8%, respectively, at 5 years, with median survival times of 448 days, 574 days, and 758 days, respectively. The CTLS group showed a slightly but not significantly better survival than the ADMOS and CDDP‐ADMOS groups ( P <0.1). Multivariate analysis indicated that the significantly important prognostic factors (in order) were extrahepatic metastasis followed by the TACE regimen, serum α‐fetoprotein levels, and portal vein involvement and that CTLS was the best of the three regimens. CONCLUSIONS Although TACE, using an effective regimen, improves clinical results, tumor factors appear to be more important when determining prognosis. Cancer 2000;88:1574–81. © 2000 American Cancer Society.