Combination treatment with intrahepatic arterial infusion and intratumoral injection chemotherapy in patients with far-advanced hepatocellular carcinoma and arterioportal or arteriovenous shunts: preliminary results
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
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-γ) 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.
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-γ) 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.
참고문헌 (20)
- Parkin DM, "Estimating the world cancer burden: Globocan 2000", Int J Cancer, 94, pp.153~156 (2001)
- Kuo YH, "Hepatocellular carcinoma surveillance and appropriate treatment options improve survival for patients with liver cirrhosis", Eur J Cancer, 46, pp.744~751 (2010)
- Marrero JA, "Prognosis of hepatocellular carcinoma: comparison of 7 staging systems in an American cohort", Hepatology, 41, pp.707~716 (2005)
- Wang JH, "The efficacy of treatment schedules according to Barcelona Clinic Liver Cancer staging for hepatocellular carcinoma-Survival analysis of 3892 patients", Eur J Cancer, 44, pp.1000~1006 (2008)
- Jang JW, "A combination therapy with transarterial chemo-lipiodolization and systemic chemo-infusion for large extensive hepatocellular carcinoma invading portal vein in comparison with conservative management", Cancer Chemotherapy and Pharmacology, 59(1), pp.9~15, Springer Verlag
- Jang JW, "Therapeutic efficacy of multimodal combination therapy using transcatheter arterial infusion of epirubicin and cisplatin, systemic infusion of 5-fluorouracil, and additional percutaneous ethanol injection for unresectable hepatocellular carcinoma", Cancer Chemother Pharmacol, 54, pp.415~420 (2004)
- Eun JR, "Hepatic arterial infusion chemotherapy using high-dose 5-fluorouracil and cisplatin with or without interferon-alpha for the treatment of advanced hepatocellular carcinoma with portal vein tumor thrombosis", Scand J Gastroenterol, 44, pp.1477~1486 (2009)
- Woo HY, "A randomized comparative study of high-dose and low-dose hepatic arterial infusion chemotherapy for intractable, advanced hepatocellular carcinoma", CANCER CHEMOTHERAPY AND PHARMACOLOGY, 65(2), pp.373~382 (2010)
- Hiyoshi Y, "The efficacy of transcatheter embolization of severe arterioportal shunts in hepatocellular carcinoma", Gan To Kagaku Ryoho, 34, pp.2093~2095 (2007)
- Murata S, "Initial experience of transcatheter arterial chemoembolization during portal vein occlusion for unresectable hepatocellular carcinoma with marked arterioportal shunts", Eur Radiol, 19, pp.2016~2023 (2009)
- van Herpen CM, "Intratumoral administration of recombinant human interleukin 12 in head and neck squamous cell carcinoma patients elicits a T-helper 1 profile in the locoregional lymph nodes", Clin Cancer Res, 10, pp.2626~2635 (2004)
- Mei K, "Antitumor efficacy of combination of interferon-gamma-inducible protein 10 gene with gemcitabine, a study in murine model", J Exp Clin Cancer Res, 27, pp.63~ (2008)
- Beatty G, "IFN-gamma-dependent inhibition of tumor angiogenesis by tumor-infiltrating CD4+ T cells requires tumor responsiveness to IFN-gamma", J Immunol, 166, pp.2276~2282 (2001)
- Nagai H, "Th1", Th2 balance: an important indicator of efficacy for intra-arterial chemotherapy, 2008, pp.62, 959~963
- Klein HO, "Combination of interferons and cytostatic drugs for treatment of advanced colorectal cancer", J Cancer Res Clin Oncol, 117(4), pp.214~220 (1991)
- Hirabayashi N, "In vitro chemosensitivity tests on human tumor xenografts by clonogenic assay: the combined use of mitomycin C with alpha- interferon or gamma-interferon", Jpn J Surg, 15, pp.279~284 (1985)
- Manara MC, "Effectiveness of Type I interferons in the treatment of multidrug resistant osteosarcoma cells", Int J Oncol, 24, pp.365~372 (2004)
- Lissat A, "Interferon-gamma sensitizes resistant Ewing's sarcoma cells to tumor necrosis factor apoptosis-inducing ligand-induced apoptosis by up-regulation of caspase-8 without altering chemosensitivity", Am J Pathol, 170, pp.1917~1930 (2007)
- Chung C, "Interferon-gamma sensitizes hepatitis B virus-expressing hepatocarcinoma cells to 5-fluorouracil through inhibition of hepatitis B virus-mediated nuclear factor-kappaB activation", Cancer Sci, 98, pp.1758~1766 (2007)
- Oie S, "The up-regulation of type I interferon receptor gene plays a key role in hepatocellular carcinoma cells in the synergistic antiproliferative effect by 5-fluorouracil and interferon-alpha", Int J Oncol, 29, pp.1469~1478 (2006)