Chemoembolization of hepatocellular carcinoma with cisplatin, doxorubicin, mitomycin-C, ethiodol, and polyvinyl alcohol: prospective evaluation of response and survival in a U.S. population

J Vasc Interv Radiol. 1999 Jun;10(6):793-8. doi: 10.1016/s1051-0443(99)70117-x.

Abstract

Purpose: To evaluate response and survival after hepatic chemoembolization with cisplatin, doxorubicin, mitomycin-C, Ethiodol, and polyvinyl alcohol in a U.S. population of patients with hepatocellular carcinoma.

Materials and methods: Thirty-eight consecutive patients were treated: 35% stage I, 62% stage II, 3% stage III. Fifty-one percent had cirrhosis. Chemoembolization was performed at approximately monthly intervals for one to seven sessions (mean, 2.2). Pretreatment and posttreatment cross-sectional imaging and alpha-fetoprotein (AFP) levels were obtained prospectively 1 month after treatment and then every 3 months. Thirty-day response was calculated by means of the the World Health Organization/Eastern Cooperative Oncology Group criteria.

Results: One patient was lost to follow-up. In seven patients, lesions became resectable after chemoembolization. Among 13 evaluable patients with initially elevated AFP level, 70% had a partial biologic response (>50% decrease in AFP), 15% had a minor response (25-50% decrease), and the remaining 15% remained stable. Among 25 patients evaluable for morphologic response, 36% had a partial response, 32% had a minor response, and 32% remained stable. No patients had progression of disease while receiving therapy. The cumulative survival was 60% at 1 year, 41% at 2 years, and 16% at 3 years. Two patients developed progressive hepatic failure. Thirty-day mortality was 3% (one patient).

Conclusion: These results compare favorably to published response and survival data for chemoembolization of advanced hepatocellular carcinoma from Asia and Europe.

Publication types

  • Comparative Study

MeSH terms

  • Antibiotics, Antineoplastic / administration & dosage
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / surgery
  • Carcinoma, Hepatocellular / therapy*
  • Chemoembolization, Therapeutic*
  • Cisplatin / administration & dosage
  • Doxorubicin / administration & dosage
  • Ethiodized Oil / administration & dosage
  • Female
  • Follow-Up Studies
  • Humans
  • Liver Cirrhosis / complications
  • Liver Failure / etiology
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery
  • Liver Neoplasms / therapy*
  • Magnetic Resonance Imaging
  • Male
  • Mitomycin / administration & dosage
  • Neoplasm Staging
  • Polyvinyl Alcohol / administration & dosage
  • Prospective Studies
  • Remission Induction
  • Survival Rate
  • Tomography, X-Ray Computed
  • United States
  • alpha-Fetoproteins / analysis

Substances

  • Antibiotics, Antineoplastic
  • Antineoplastic Agents
  • alpha-Fetoproteins
  • Mitomycin
  • Ethiodized Oil
  • Doxorubicin
  • Polyvinyl Alcohol
  • Cisplatin