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Combined intraarterial 5‐fluorouracil and subcutaneous interferon‐α therapy for advanced hepatocellular carcinoma with tumor thrombi in the major portal branches
Author(s) -
Sakon Masato,
Nagano Hiroaki,
Dono Keizo,
Nakamori Shoji,
Umeshita Koji,
Yamada Akira,
Kawata Sumio,
Imai Yasuharu,
Iijima Shohei,
Monden Morito
Publication year - 2002
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/cncr.10246
Subject(s) - medicine , leukopenia , regimen , fluorouracil , hepatocellular carcinoma , methotrexate , gastroenterology , alpha interferon , surgery , combination therapy , hepatic arterial infusion , interferon alfa , chemotherapy , cancer , interferon , immunotherapy , metastasis , immunology
BACKGROUND The prognosis of hepatocellular carcinoma (HCC) invading into the major branches of the portal vein (Vp3) is extremely poor. METHODS Eleven consecutive patients with HCC and Vp3 were treated with 2–6 cycles of a “basic” combination therapy consisting of continuous arterial infusion of 5‐fluorouracil (450–500 mg/day, for the initial 2 weeks) and subcutaneous injection of interferon‐α (5 million international units, 3 times/week, 4 weeks). In the first 3 patients, methotrexate (90 mg/day 1 of every week), cisplatin (10 mg/day), and leucovorin (30 mg/days 2 and 3 of every week) also were administered for the initial 2 weeks (“full” regimen). RESULTS In 8 (73%) of 11 patients, an objective response (complete response [CR] or partial response [PR]) was observed with marked regression of tumor and decrease in tumor markers. The use of the full regimen was associated with objective response in all patients; instead, they developed thrombocytopenia or leukopenia. In the subsequent 8 patients with basic regimen, 5 patients showed CR (2 cases) or PR (3 cases; objective response rate, 63%), and leukopenia was observed only in 1 patient. CONCLUSIONS Simple combination therapy with subcutaneous interferon‐α and intraarterial 5‐fluorouracil therefore is a promising treatment modality for intractable HCC with Vp3. Cancer 2002;94:435–42. © 2002 American Cancer Society.