Korean J Gastroenterol.  2005 Feb;45(2):118-124.

Efficacy of Hepatic Arterial Infusion Therapy for Advanced Hepatocellular Carcinoma Using 5-Fluorouracil, Epirubicin and Mitomycin-C

• Hwang JY
• Jang BK
• Kwon KM
• Chung WJ
• Park KS
• Cho KB
• Hwang JS
• Ahn SH
• Kim GC
• Kim YH
• Choi JS
• Kwon JH

Abstract

BACKGROUND/AIMS: Prognosis of advanced hepatocellular carcinoma (HCC) treated by conventional therapies has been considered to be poor. The aim of this study was to evaluate the efficacy of hepatic arterial infusion therapy (HAIT) using FEM (5-fluorouracil, epirubicin, mitomycin-C) regimen for advanced HCC. METHODS: Eighteen patients received repeated HAIT using an implanted drug delivery system. Of the 18 patients, 8 patients had HCC with portal vein tumor thrombosis, 9 patients had recurrent HCC after transarterial chemoembolization (TACE) and 1 patient after surgical resection. The patients received 5-fluorouracil (330 mg/m2, every week), epirubicin (30 mg/m2, every 4 weeks) and mitomycin-C (2.7 mg/m2, every 2 weeks). RESULTS: Mean age was 51 years. The response rate (complete response+partial response) by tumor size on abdominal CT was 38.9%. Survival ranged from 2 to 24 months and the median survival time was 8 months. The cumulative survival rate of responders group was significantly higher than non-responders group (p=0.0385). The mean levels of serum alpha-FP and PIVKA-II in responders group decreased after HAIT (3,179 ng/mL and 2,850 ng/mL) than before (11,218 ng/mL and 4,396 ng/mL), but not significantly. Chemotherapy-related side effects were nausea, vomiting and alopecia. Three patients had catheter-related complications. One patient developed gastric ulcer. CONCLUSIONS: HAIT using FEM regimen is a useful therapeutic option for patients with advanced HCC with portal vein tumor thrombosis or ineffective response to other therapies.

Keyword

Hepatocellular carcinoma; Hepatic arterial infusion therapy; 5-FU; Epirubicin; Mitomycin-C

MeSH Terms

Adult
Aged
Antineoplastic Combined Chemotherapy Protocols/*administration & dosage
Carcinoma, Hepatocellular/*drug therapy/mortality/pathology
Epirubicin/administration & dosage
Female
Fluorouracil/administration & dosage
Humans
Infusion Pumps, Implantable
Infusions, Intra-Arterial
Liver Neoplasms/*drug therapy/mortality/pathology
Male
Middle Aged
Mitomycin/administration & dosage
Survival Rate