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Quadruple chemotherapy versus radiotherapy in treatment of primary hepatocellular carcinoma
Author(s) -
Cochrane A. M. G.,
MurrayLyon I. M.,
Brinkley D. M.,
Williams Roger
Publication year - 1977
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197708)40:2<609::aid-cncr2820400203>3.0.co;2-l
Subject(s) - medicine , chemotherapy , radiation therapy , cyclophosphamide , vincristine , methotrexate , surgery , gastroenterology , oncology
Although there have been many therapeutic trials of chemotherapy for primary hepatoma, few have been controlled and the results of treatment have been disappointing. The present report is concerned with a controlled trial of chemotherapy alone versus radiotherapy followed by chemotherapy in 18 patients with primary hepatoma. Ten patients received quadruple chemotherapy (5‐flurouracil, cyclophosphamide, methotrexate, and vincristine). These patients survived considerably longer (21 weeks) than eight patients who received radiotherapy followed by the same chemotherapy regime (12 weeks). Further analysis of these results suggested that length of survival in both treatment groups was related to age, length of history, levels of serum bilirubin and aspartate transaminase, and to the presence of cirrhosis or ascites. According to these criteria, patients were subdivided into two grades of disease. For patients with less severe disease (grade A), median survival after chemotherapy alone (54 weeks) was longer than after radiotherapy followed by chemotherapy (24 weeks). Survival of patients with severe disease (grade B) was equally poor in both treatment groups (5 weeks, chemotherapy; 7.5 weeks radiotherapy followed by chemotherapy). In conclusion, these results show that quadruple chemotherapy alone is a valuable form of therapy for grade A patients. Neither form of therapy, however, was of any benefit for grade B patients. Cancer 40:609–614, 1977.