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World J Gastroenterol. Jan 14, 2007; 13(2): 280-284
Published online Jan 14, 2007. doi: 10.3748/wjg.v13.i2.280
Twenty-four hour intra-arterial infusion of 5-fluorouracil, cisplatin, and leucovorin is more effective than 6-hour infusion for advanced hepatocellular carcinoma
Hidenari Nagai, Masahiro Kanayama, Katsuya Higami, Kouichi Momiyama, Akiko Ikoma, Naoki Okano, Katsuhiko Matsumaru, Manabu Watanabe, Koji Ishii, Yasukiyo Sumino, Kazumasa Miki
Hidenari Nagai, Masahiro Kanayama, Katsuya Higami, Kouichi Momiyama, Akiko Ikoma, Naoki Okano, Katsuhiko Matsumaru, Manabu Watanabe, Koji Ishii, Yasukiyo Sumino, Kazumasa Miki, Division of Gastroenterology and Hepatology, Toho University Medical Center, Omori Hospital, 6-11-1, Omorinishi, Ota-ku, Tokyo 143-8541, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Hidenari Nagai, Division of Gastro-enterology and Hepatology, Toho University Medical Center, Omori Hospital, 6-11-1, Omorinishi, Ota-ku, Tokyo 143-8541, Japan. hidenari@aol.com
Telephone: +81-3-37624151 Fax: +81-3-37638542
Received: June 19, 2006
Revised: July 25, 2006
Accepted: August 22, 2006
Published online: January 14, 2007
Abstract

AIM: To evaluate the time dependence of intra-arterial 5-fluorouracil (5-FU) therapy for advanced hepatocellular carcinoma (aHCC).

METHODS: Thirty-seven adult Japanese patients who had aHCC and liver cirrhosis were treated with combined intra-arterial 5-FU, cisplatin (CDDP), and leucovorin (LV). The Japan Integrated Staging score (JIS score) of each patient was 3 or more. The patients were divided into two groups, after which the 15 patients in group S were treated with 6-h infusion chemotherapy (LV at 12 mg/h, CDDP at 10 mg/h, and 5-FU at 250 mg/m2 per 4 h) and the 22 patients in group L were treated with 24-h infusion chemotherapy (LV at 12 mg/h, CDDP at 10 mg/h, and 5-FU at 250 mg/m2 per 22 h). Continuous infusion chemotherapy was performed via the proper hepatic artery every 5 d for 4 wk using an implanted drug reservoir.

RESULTS: The percentages of patients with a partial response after 4 wk of chemotherapy were 6.7% in group S and 31.8% in group L. The survival of group L was significantly better than that of group S, with the median survival time being 496 d in group L and 226 d in group S (p < 0.05).

CONCLUSION: Continuous 24-h intra-arterial infusion is more effective for aHCC and can markedly prolong survival time as compared to 6-h infusion.

Keywords: 5-fluorouracil; Cisplatin; Advanced hepato-cellular carcinoma; Liver cirrhosis; Intra-arterial chemotherapy