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

• Published in: Clinical and molecular hepatology Vol. 17; no. 2; pp. 120 - 129
• Main Authors: Kim, Ja Seon, Park, Young Min, Kim, Nha Young, Yun, Han Kyeol, Lee, Ki Jong, Kim, Bo Hyun, Park, Sang Jong, Yeon, Jae Woo, Jung, Guhung
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Association for the Study of the Liver 01-06-2011; The Korean Association for the Study of the Liver; 대한간학회
• Subjects: Aged; Angiography; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bone marrow; Cancer therapies; Carcinoma, Hepatocellular - diagnostic imaging; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - pathology; Chemotherapy; Cisplatin - administration & dosage; Epirubicin - administration & dosage; Fluorouracil - administration & dosage; Hepatic Artery; Humans; Infusions, Intra-Arterial; Injections, Intramuscular; Interferon-gamma - administration & dosage; Leukocytes; Life sciences; Liver cancer; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - drug therapy; Liver Neoplasms - pathology; Male; Medical imaging; Medical prognosis; Metastasis; Original; Patients; Pharmaceuticals; Recombinant Proteins; Thrombosis; Tomography, X-Ray Computed; Tumor Burden; Tumors; Veins & arteries; 내과학; South Korea; Seoul South Korea
• ISSN: 1738-222X; 2287-2728; 2287-285X; 2093-8047
• DOI: 10.3350/kjhep.2011.17.2.120

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).
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.
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.
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.