Korean J Hepatol.  2011 Jun;17(2):120-129. 10.3350/kjhep.2011.17.2.120.

Combination treatment with intrahepatic arterial infusion and intratumoral injection chemotherapy in patients with far-advanced hepatocellular carcinoma and arterioportal or arteriovenous shunts: preliminary results

• Kim JS
• Park YM
• Kim NY
• Yun HK
• Lee KJ
• Kim BH
• Park SJ
• Yeon JW
• Jung G

• KMID: 1015571
• DOI: http://doi.org/10.3350/kjhep.2011.17.2.120

Abstract

BACKGROUND/AIMS
Combination treatment consisting of hepatic arterial infusion chemotherapy with epirubicin and cisplatin (HAIC-EC) and systemic infusion of low-dose 5-fluorouracil (5-FU) are sometimes effective against advanced hepatocellular carcinoma (HCC). However, there is no effective treatment for advanced HCCs with arterioportal shunts (APS) or arteriovenous shunts (AVS).
METHODS
We investigated a response and adverse events of a new combination protocol of repeated HAIC-EC and percutaneous intratumoral injection chemotherapy with a mixture of recombinant interferon-gamma (IFN-gamma) and 5-FU (PIC-IF) in patients with far-advanced HCCs with large APSs or AVSs.
RESULTS
There was a complete response (CR) for the large vascular shunts in all three patients and for all tumor burdens in two patients. Significant side effects were flu-like symptoms (grade 2) and bone marrow suppression (grade 2 or 3) after each cycle, but these were well-tolerated.
CONCLUSIONS
These results suggest that the combination of HAIC-EC and PIC-IF is a new and promising approach for advanced HCC accompanied by a large APS or AVS.

Keyword

Hepatocellular carcinoma; Arterioportal shunt; Intratumoral injection chemotherapy; Interferon-gamma

MeSH Terms

Aged
Angiography
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
Carcinoma, Hepatocellular/*drug therapy/pathology/radiography
Cisplatin/administration & dosage
Epirubicin/administration & dosage
Fluorouracil/administration & dosage
Hepatic Artery
Humans
Infusions, Intra-Arterial
Injections, Intramuscular
Interferon-gamma, Recombinant/administration & dosage
Liver Neoplasms/*drug therapy/pathology/radiography
Male
Tomography, X-Ray Computed
Tumor Burden