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J Surg Oncol. 2002 Jul;80(3):143-8.

Hepatic arterial infusion of 5-fluorouracil and cisplatin for unresectable or recurrent hepatocellular carcinoma with tumor thrombus of the portal vein.

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  • 1Department of Surgery II, Hiroshima University, Faculty of Medicine, Hiroshima, Japan. titamoto@mua.biglobe.ne.jp

Abstract

BACKGROUND AND OBJECTIVES:

This study was designed to evaluate the efficacy of hepatic arterial infusion of 5-fluorouracil (5-FU) and cisplatin (CDDP) for unresectable or recurrent hepatocellular carcinoma (HCC) with tumor thrombus of the trunk or first branches of the portal vein (PVTT).

METHODS:

Seven unresectable or recurrent HCC patients with PVTT were enrolled in this study. A one-week course of chemotherapy consisted of intraarterial administration of CDDP (10 mg on days 1-5) for 1 h and 5-FU (250 mg on days 1-5) for 24 h, followed by cessation of administration for the subsequent 2 days (days 6 and 7). Three or more sequential courses of chemotherapy were given through an implanted reservoir.

RESULTS:

Serum alpha-fetoprotein (AFP) levels before the chemotherapy were >20 ng/ml in six of the seven patients. Serum AFP levels were decreased in four of the six patients after chemotherapy, including two patients (cases 1 and 7) whose AFP levels later returned to normal. Six of the seven patients had measurable lesions in the liver, with a response rate of 33%. In three of the seven patients (43%), PVTTs decreased in size or disappeared after chemotherapy. The mean and median survival periods of all patients were 8.0 and. 7.5 months, respectively.

CONCLUSIONS:

The chemotherapy described in this report is beneficial in terms of survival for HCC patients with PVTT for whom transcatheter arterial embolization or surgical treatment is contraindicated.

Copyright 2002 Wiley-Liss, Inc.

PMID:
12115797
[PubMed - indexed for MEDLINE]
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