Combination therapy consisting of arterial infusion chemotherapy (EPF, EAP) and transcatheter arterial embolization (TAE)

• Published in: Cancer chemotherapy and pharmacology 1994-01, Vol.33 Suppl (S1), p.S79-S83
• Main Authors: Yodono, H, Takekawa, S D, Tarusawa, K, Ikami, I, Kanehira, J, Saito, Y, Takahashi, S, Sasaki, T, Nishi, N, Kimura, T
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Carcinoma, Hepatocellular - diagnostic imaging; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - therapy; Chemoembolization, Therapeutic; Cisplatin - administration & dosage; Combined Modality Therapy; Doxorubicin - administration & dosage; Etoposide - administration & dosage; Female; Fluorouracil - administration & dosage; Humans; Infusions, Intra-Arterial; Iodized Oil - administration & dosage; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - drug therapy; Liver Neoplasms - therapy; Male; Middle Aged; Survival Rate; Tomography, X-Ray Computed
• ISSN: 0344-5704; 1432-0843
• DOI: 10.1007/BF00686673

From January 1988 to January 1993, 45 patients with unresectable advanced hepatocellular carcinoma (HCC) were treated with a new combination therapy consisting of arterial infusion chemotherapy and TAE. The combination therapy was performed according to our treatment schedule as follows: two courses of arterial infusion chemotherapy were given first, and then transcatheter arterial embolization (TAE) using a mixture of Lipiodol and cisplatin powder was performed. Two arterial infusion chemotherapeutic regimens were employed: EPF (etoposide, cisplatin, and 5-fluorouracil) and EAP (etoposide, Adriamycin or Epi-adriamycin, and cisplatin). The anticancer drugs were infused through a catheter inserted into the proper or common hepatic artery. Assessment was made of the anticancer effect and survival rate of each treatment method. The response to each therapy was evaluated on the basis of CT performed prior to and after the treatment. In the EPF.TAE group, the response rate was about 46%, whereas in the EAP.TAE group it was 48%. Overall, 21 of 45 patients attained a regression rate of 50% or more. Furthermore, daughter nodules decreased in size or disappeared in about 67% of 15 patients. Additionally, tumor thrombi tended to show a similar response. In all of the cases, the average duration of survival was 30.3 months, and the 1-year survival value was 68%, the 2-year survival value was 44%, and the 3-year survival value was 35%. These results were superior to those obtained with TAE therapy alone.