Combination therapy of intraarterial 5‐fluorouracil and systemic interferon‐alpha for advanced hepatocellular carcinoma with portal venous invasion

BACKGROUND Hepatocellular carcinoma (HCC) with portal venous invasion (PVI) has a very poor prognosis, with a median survival of 3 months and virtually no survival at 1 year. The combination of intraarterial 5‐fluorouracil (FU) and systemic interferon‐α (IFNα) was recently reported to be effective a...

Full description

Saved in:
Bibliographic Details
Published in:Cancer 2006-05, Vol.106 (9), p.1990-1997
Main Authors: Obi, Shuntaro, Yoshida, Haruhiko, Toune, Risa, Unuma, Tadao, Kanda, Miho, Sato, Shinpei, Tateishi, Ryosuke, Teratani, Takuma, Shiina, Shuichiro, Omata, Masao
Format: Article
Language:English
Subjects:
Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biological and medical sciences
carcinoma
Carcinoma, Hepatocellular - drug therapy
Carcinoma, Hepatocellular - mortality
drug therapy
Female
fluorouracil
Fluorouracil - administration & dosage
Fluorouracil - adverse effects
Gastroenterology. Liver. Pancreas. Abdomen
hepatocellular
Humans
Infusions, Intra-Arterial
Interferon-alpha - administration & dosage
Interferon-alpha - adverse effects
interferons
Liver Neoplasms - drug therapy
Liver Neoplasms - mortality
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Male
Medical sciences
Middle Aged
portal vein
Portal Vein - pathology
Tumors
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:BACKGROUND Hepatocellular carcinoma (HCC) with portal venous invasion (PVI) has a very poor prognosis, with a median survival of 3 months and virtually no survival at 1 year. The combination of intraarterial 5‐fluorouracil (FU) and systemic interferon‐α (IFNα) was recently reported to be effective against HCC with PVI, but these were small pilot studies. METHODS One hundred and sixteen patients with HCC with PVI received IFNα (5,000,000 U intramuscularly on Days 1, 3, and 5 of each week of treatment) and 5‐FU (500 mg into hepatic artery on Days 1‐5 of the first and second week of each 4‐week cycle). The therapy was either terminated at the end of the first cycle in cases with progressive disease, or continued for at least 3 cycles, when responses to treatment were evaluated by Eastern Cooperative Oncology Group criteria. The survival rate was compared with that of historical controls (n = 40). RESULTS Nineteen (16%) patients showed complete response and another 42 (36%) showed partial response. Adverse events were limited to nausea and appetite loss. The survival rates at 12 and 24 months among overall patients were 34% and 18%, respectively, in contrast to 15% and 5% among the historical controls. Survival rates at 12 and 24 months were 81% and 59% among complete responders, respectively, and 43% and 18% among partial responders. CONCLUSION The combination therapy with 5‐FU and IFN was safe, and substantially improved the survival rate among the complete responders. These results provide a rationale for future randomized controlled trials. Cancer 2006. © 2006 American Cancer Society. The combination of intraarterial 5‐fluorouracil (FU) and systemic interferon‐α (IFNα) was effective against hepatocellular carcinoma with portal venous invasion. The combination therapy was safe, and substantially improved survival rates among the complete responders.
ISSN:0008-543X
1097-0142
DOI:10.1002/cncr.21832