Activity and tolerability of courses of intra-arterial chemotherapy followed by chemoembolization in unresectable hepatocellular carcinoma

Tumori. 1998 Nov-Dec;84(6):673-6. doi: 10.1177/030089169808400612.

Abstract

Aims and background: We previously reported encouraging response rates and survival with combined intra-arterial (i.a.) chemotherapy and chemoembolization in unresectable hepatocellular carcinoma. We therefore evaluated a new program combining three courses of i.a. chemotherapy with chemoembolization administered every 28 days.

Patients and methods: The treatment regimen consisted of L-leucovorin (100 mg/m2 i.v.), fluorouracil (800 mg/m2 i.a.), and carboplatin (250 mg/m2 i.a.). Chemoembolization with mitoxantrone (10 mg/m2) plus ethiodized oil and gelatin sponge was performed immediately after. The same treatment was given every 28 days for 3 times.

Results: Twenty-eight patients entered the study and were assessable for response and side effects. There were 24 males and 4 females (median age, 68 yrs; range, 42-75). TNM stage was II-III in 20 and IVA in 8; 17 were Child's A and 11 Child's B. Baseline alpha-fetoprotein was elevated in 15, and there was cirrhosis in 23. Twelve patients had a partial response (43%; 95% confidence interval, 24-63%), 13 had stabilization, and 3 progressive disease. Median survival was 16.6 months (range, 2-24). Sixteen patients had grade I-II pain and 14 grade I-II fever.

Conclusions: Our results indicate that the regimen is safe and well tolerated. Despite 43% objective remissions, our results do not seem better than those obtained with less intensive regimens.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carboplatin / administration & dosage
  • Carcinoma, Hepatocellular / drug therapy*
  • Chemoembolization, Therapeutic* / methods
  • Ethiodized Oil / administration & dosage
  • Female
  • Fluorouracil / administration & dosage
  • Gelatin Sponge, Absorbable
  • Humans
  • Infusions, Intra-Arterial
  • Leucovorin / administration & dosage
  • Liver Neoplasms / drug therapy*
  • Male
  • Middle Aged
  • Mitoxantrone / administration & dosage
  • Treatment Outcome

Substances

  • Ethiodized Oil
  • Carboplatin
  • Mitoxantrone
  • Leucovorin
  • Fluorouracil