[Epirubicin in the treatment of malignant obstructive jaundice]

Zhonghua Zhong Liu Za Zhi. 2006 May;28(5):397-9.
[Article in Chinese]

Abstract

Objective: To evaluate the safety and efficiency of epirubicin in the treatment of malignant obstructive jaundice (MOJ).

Methods: Thirty-nine patients with diagnosis of MOJ, whose serum total bilirubin (TB) had not dropped to normal level after stent placement or percutaneous transhepatic biliary drainage, received trans-arterial chemoembolization (TACE). During TACE, epirubicin emulsion containing pharmorubicin at dose of 30 mg/m(2) was used. The toxicity and hepatic injury was observed according to WHO anticancer drug toxicity criterion and Child-Pugh classification criterion, respectively. The time of jaundice recurrence and survival were also observed during follow-up.

Results: Median total serum bilirubin in 39 patients was 72.7 micromol/L (range: 52.1 - 91.4 micromol/L) before TACE. The dose of pharmorubicin was 40 - 60 mg with a median of 55.0 mg and the amount of lipiodol was 2 - 25 ml. Decrease in white blood cell count was observed: grade I in 41.0% of patients, grade II in 35.9% and grade III - IV in 15.4%. Grade III - IV nausea and vomiting developed in 100% of the patients. Hepatic injury became aggravated in 8 from A to B class patients, in one from A to C class, and in 3 from B to C class according to Child-Pugh classification criterion. No cardiac toxicity was observed in this series. The median survival time was 6.0 months with a range of 2 to 72 months. Jaundice recurred in 19 patients (48.7%) with a medium jaundice recurrence time of 9.0 months (range: 2 - 20 months).

Conclusion: Epirubicin-lipiodol emulsion at a dose of 30 mg/m(2) is safe and efficient in the management of patients with malignant obstructive jaundice with total serum bilirubin between 51 and 100 micromol/L after biliary drainage.

Publication types

  • English Abstract

MeSH terms

  • Adult
  • Aged
  • Antibiotics, Antineoplastic / administration & dosage
  • Bile Duct Neoplasms / complications
  • Bilirubin / blood
  • Carcinoma, Hepatocellular / complications
  • Chemoembolization, Therapeutic*
  • Epirubicin / administration & dosage*
  • Female
  • Follow-Up Studies
  • Humans
  • Iodized Oil / administration & dosage
  • Jaundice, Obstructive / etiology
  • Jaundice, Obstructive / therapy*
  • Liver Neoplasms / complications
  • Male
  • Middle Aged
  • Recurrence
  • Survival Rate

Substances

  • Antibiotics, Antineoplastic
  • Epirubicin
  • Iodized Oil
  • Bilirubin