Improved survival for hepatocellular carcinoma with portal vein tumor thrombosis treated by intra-arterial chemotherapy combining etoposide, carboplatin, epirubicin and pharmacokinetic modulating chemotherapy by 5-FU and enteric-coated tegafur/uracil: A pilot study

doi:10.3748/wjg.v13.i41.5465

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Nov 7, 2007 (publication date) through Nov 4, 2024

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Nov 7, 2007; 13(41): 5465-5470
Published online Nov 7, 2007. doi: 10.3748/wjg.v13.i41.5465

Improved survival for hepatocellular carcinoma with portal vein tumor thrombosis treated by intra-arterial chemotherapy combining etoposide, carboplatin, epirubicin and pharmacokinetic modulating chemotherapy by 5-FU and enteric-coated tegafur/uracil: A pilot study

Toru Ishikawa, Michitaka Imai, Hiroteru Kamimura, Atsunori Tsuchiya, Tadayuki Togashi, Kouji Watanabe, Kei-ichi Seki, Hironobu Ohta, Toshiaki Yoshida, Tomoteru Kamimura

Toru Ishikawa, Michitaka Imai, Hiroteru Kamimura, Atsunori Tsuchiya, Tadayuki Togashi, Kouji Watanabe, Kei-ichi Seki, Hironobu Ohta, Toshiaki Yoshida, Tomoteru Kamimura, Department of Gastroenterology and Hepatology, Saiseikai Niigata Second Hospital, Niigata 950-1104, Japan

Author contributions: All authors contributed equally to the work.

Correspondence to: Toru Ishikawa, MD, Department of Gastroenterology and Hepatology, Saiseikai Niigata Second Hospital, Teraji 280-7, Niigata 950-1104, Japan. toruishi@ngt.saiseikai.or.jp

Telephone: +81-25-2336161 Fax: +81-25-2338880

Received: June 23, 2007
Revised: August 6, 2007
Accepted: September 4, 2007
Published online: November 7, 2007

Abstract

AIM: To investigate the poor prognosis of HCC with PVTT, we evaluated the efficacy by a new combination chemotherapy for advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT).

METHODS: From 2002 to 2007, a total of 10 consecutive patients with Stage IVA HCC accompanied by PVTT were studied prospectively to examine the efficacy of treatment by intra-arterial infusion of a chemotherapeutic agents consisting of etoposide, carboplatin, epirubicin and pharmacokinetic modulating chemotherapy by 5-FU and enteric-coated tegafur/uracil.

RESULTS: The mean course of chemotherapy was 14.4 (range, 9-21) mo. One patient showed complete response (CR) with disappearance of HCC and PVTT after treatment, and the two patients showed partial response (PR), response rate (CR + PR/All cases 30%). The median survival time after the therapy was 457.2 d. The one-year survival rate was 70%. Adverse reactions were tolerable.

CONCLUSION: Although the prognosis of most patients with Stage IVA HCC by PVTT is poor, our combination chemotherapy may induces long-term survival and is an effective treatment and produced anti-tumor activity with tolerable adverse effects in patients for advanced Stage IVA HCC accompanied by PVTT.

Keywords: Hepatocellular carcinoma; Portal vein tumor thrombus; Intra-arterial regional chemotherapy