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Erschienen in: Medical Oncology 3/2015

01.03.2015 | Original Paper

Arterial infusion of 5-fluorouracil combined with subcutaneous injection of pegylated interferon alpha-2b in treating unresectable hepatocellular carcinoma with portal vein tumor thrombus

verfasst von: Jian Wu, Wen-Jin Huang, Huan-Yu Wang, Ya-Feng Wang, Bao-Gang Peng, Qi Zhou

Erschienen in: Medical Oncology | Ausgabe 3/2015

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Abstract

This study aimed to evaluate the efficacy of arterial infusion of 5-fluorouracil (5-FU) combined with subcutaneous injection of pegylated interferon alpha-2b (PEG-IFNα-2b) on unresectable HCC with PVTT and to determine the potential survival benefits of patients from this therapy. From January 2007 to August 2009, HCC patients with PVTT were assigned to undergo arterial infusion of 5-FU with subcutaneous injection of PEG-IFNα-2b or palliative therapy. A total of 105 HCC patients (94 males and 11 females) aged 24–78 years with portal vein thrombosis were randomly assigned to 5-FU/PEG-IFNα-2b group (n = 55) or control group (n = 50). The median progression-free survival (PFS) was 10 months, and the median overall survival (OS) was 12 months for all patients. The 6- and 12-month OS rates were significantly higher in 5-FU/PEG-IFNα-2b group than in control group (81.04 vs. 22.72%, 48.03 vs. 0%, both P < 0.05). The median OS and PFS were significantly longer in 5-FU/PEG-IFNα-2b group than in control group (14.7 vs. 4.5 months, 12.5 vs. 9 months, both P < 0.05). For unresectable HCC with PVTT, arterial infusion of 5-FU combined with subcutaneous injection of PEG-IFNα-2b reduces tumor size obviously, prolongs patient survival, and causes no severe adverse events.
Literatur
1.
Zurück zum Zitat El-Serag HB, Rudolph KL. Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology. 2007;132(7):2557–76.CrossRefPubMed El-Serag HB, Rudolph KL. Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology. 2007;132(7):2557–76.CrossRefPubMed
2.
3.
Zurück zum Zitat Lau WY, Lai EC, Yu SC. Management of portal vein tumor thrombus. In: Wy L, ed. Hepatocellular carcinoma. Singapore: World Scientific Publishing Co. Pte. Ltd.; 2008. p 1–24. Lau WY, Lai EC, Yu SC. Management of portal vein tumor thrombus. In: Wy L, ed. Hepatocellular carcinoma. Singapore: World Scientific Publishing Co. Pte. Ltd.; 2008. p 1–24.
4.
Zurück zum Zitat Chen XP, Qiu FZ, Wu ZD, et al. Effects of location and extension of portal vein tumor thrombus on long-term outcomes of surgical treatment for hepatocellular carcinoma. Ann Surg Oncol. 2006;13(7):940–6.CrossRefPubMed Chen XP, Qiu FZ, Wu ZD, et al. Effects of location and extension of portal vein tumor thrombus on long-term outcomes of surgical treatment for hepatocellular carcinoma. Ann Surg Oncol. 2006;13(7):940–6.CrossRefPubMed
5.
Zurück zum Zitat Shi J, Lai EC, Li N, et al. Surgical treatment of hepatocellular carcinoma with portal vein tumor thrombus. Ann Surg Oncol. 2010;17(8):2073–80.CrossRefPubMed Shi J, Lai EC, Li N, et al. Surgical treatment of hepatocellular carcinoma with portal vein tumor thrombus. Ann Surg Oncol. 2010;17(8):2073–80.CrossRefPubMed
6.
Zurück zum Zitat Chung JW, Park JH, Han JK, et al. Hepatic tumors: predisposing factors for complications of transcatheter oily chemoembolization. Radiology. 1996;198(1):33–40.CrossRefPubMed Chung JW, Park JH, Han JK, et al. Hepatic tumors: predisposing factors for complications of transcatheter oily chemoembolization. Radiology. 1996;198(1):33–40.CrossRefPubMed
7.
Zurück zum Zitat Patt YZ, Yoffe B, Charnsangavej C, et al. Low serum alpha-fetoprotein level in patients with hepatocellular carcinoma as a predictor of response to 5-FU and interferon-alpha-2b. Cancer. 1993;72:2574–82.CrossRefPubMed Patt YZ, Yoffe B, Charnsangavej C, et al. Low serum alpha-fetoprotein level in patients with hepatocellular carcinoma as a predictor of response to 5-FU and interferon-alpha-2b. Cancer. 1993;72:2574–82.CrossRefPubMed
8.
Zurück zum Zitat Sakon M, Nagano H, Dono K, et al. Combined intraarterial 5-fluorouracil and subcutaneous interferon-alpha therapy for advanced hepatocellular carcinoma with tumor thrombi in the major portal branches. Cancer. 2002;94(2):435–42.CrossRefPubMed Sakon M, Nagano H, Dono K, et al. Combined intraarterial 5-fluorouracil and subcutaneous interferon-alpha therapy for advanced hepatocellular carcinoma with tumor thrombi in the major portal branches. Cancer. 2002;94(2):435–42.CrossRefPubMed
9.
Zurück zum Zitat Obi S, Yoshida H, Toune R, et al. Combination therapy of intraarterial 5-fluorouracil and systemic interferon-alpha for advanced hepatocellular carcinoma with portal venous invasion. Cancer. 2006;106(9):1990–7.CrossRefPubMed Obi S, Yoshida H, Toune R, et al. Combination therapy of intraarterial 5-fluorouracil and systemic interferon-alpha for advanced hepatocellular carcinoma with portal venous invasion. Cancer. 2006;106(9):1990–7.CrossRefPubMed
10.
Zurück zum Zitat Nagano H, Miyamoto A, Wada H, et al. Interferon-alpha and 5-fluorouracil combination therapy after palliative hepatic resection in patients with advanced hepatocellular carcinoma, portal venous tumor thrombus in the major trunk, and multiple nodules. Cancer. 2007;110(11):2493–501.CrossRefPubMed Nagano H, Miyamoto A, Wada H, et al. Interferon-alpha and 5-fluorouracil combination therapy after palliative hepatic resection in patients with advanced hepatocellular carcinoma, portal venous tumor thrombus in the major trunk, and multiple nodules. Cancer. 2007;110(11):2493–501.CrossRefPubMed
11.
Zurück zum Zitat Kasai K, Kuroda H, Ushio A, Sawara K, Takikawa Y, Suzuki K. Evaluation of newly developed combination therapy of intra-arterial 5-fluorouracil and systemic pegylated interferon alpha-2b for advanced hepatocellular carcinoma with portal venous invasion: preliminary results. Hepatol Res. 2009;39:117–25.CrossRefPubMed Kasai K, Kuroda H, Ushio A, Sawara K, Takikawa Y, Suzuki K. Evaluation of newly developed combination therapy of intra-arterial 5-fluorouracil and systemic pegylated interferon alpha-2b for advanced hepatocellular carcinoma with portal venous invasion: preliminary results. Hepatol Res. 2009;39:117–25.CrossRefPubMed
12.
Zurück zum Zitat Kasai K, Ushio A, Kasai Y, et al. Combination therapy of intra-arterial 5-fluorouracil and systemic pegylated interferon alpha-2b for advanced hepatocellular carcinoma. Int J Clin Oncol. 2011;16:221–9.CrossRefPubMed Kasai K, Ushio A, Kasai Y, et al. Combination therapy of intra-arterial 5-fluorouracil and systemic pegylated interferon alpha-2b for advanced hepatocellular carcinoma. Int J Clin Oncol. 2011;16:221–9.CrossRefPubMed
13.
Zurück zum Zitat Kasai K, Ushio A, Kasai Y, et al. Therapeutic efficacy of combination therapy with intra-arterial 5-fluorouracil and systemic pegylated interferon α-2b for advanced hepatocellular carcinoma with portal venous invasion. Cancer. 2011. doi:10.1002/cncr.26648.PubMed Kasai K, Ushio A, Kasai Y, et al. Therapeutic efficacy of combination therapy with intra-arterial 5-fluorouracil and systemic pegylated interferon α-2b for advanced hepatocellular carcinoma with portal venous invasion. Cancer. 2011. doi:10.​1002/​cncr.​26648.PubMed
14.
Zurück zum Zitat Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000;92(3):205–16.CrossRefPubMed Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000;92(3):205–16.CrossRefPubMed
15.
Zurück zum Zitat Cedurone A, Rapaccini GL, Pompili M, et al. Portal vein thrombosis complicating hepatocellular carcinoma: value of ultrasound guided fine needle biopsy of the thrombus in the therapeutic management. Liver. 1996;16:94–8.CrossRef Cedurone A, Rapaccini GL, Pompili M, et al. Portal vein thrombosis complicating hepatocellular carcinoma: value of ultrasound guided fine needle biopsy of the thrombus in the therapeutic management. Liver. 1996;16:94–8.CrossRef
16.
Zurück zum Zitat Llovert JM, Bustamante J, Castells A, et al. Natural history of untreated nonsurgical hepatocellular carcinoma: rationale for the design and evaluation of therapeutic trials. Hepatology. 1999;29:62–7.CrossRef Llovert JM, Bustamante J, Castells A, et al. Natural history of untreated nonsurgical hepatocellular carcinoma: rationale for the design and evaluation of therapeutic trials. Hepatology. 1999;29:62–7.CrossRef
17.
Zurück zum Zitat Stehlin JS Jr, de Ipolyi PD, Greeff PJ, McGaff CJ Jr, Davis BR, McNary L. Treatment of cancer of the liver: twenty years experience with infusion and resection in 414 patients. Ann Surg. 1988;208:23–5.PubMedCentralCrossRefPubMed Stehlin JS Jr, de Ipolyi PD, Greeff PJ, McGaff CJ Jr, Davis BR, McNary L. Treatment of cancer of the liver: twenty years experience with infusion and resection in 414 patients. Ann Surg. 1988;208:23–5.PubMedCentralCrossRefPubMed
18.
Zurück zum Zitat Doci R, Bignami P, Bozzetti F, et al. Intrahepatic chemotherapy for unresectable hepatocellular carcinoma. Cancer. 1988;61:1983–7.CrossRefPubMed Doci R, Bignami P, Bozzetti F, et al. Intrahepatic chemotherapy for unresectable hepatocellular carcinoma. Cancer. 1988;61:1983–7.CrossRefPubMed
19.
Zurück zum Zitat Iwamiya T, Sawada S, Ohta Y. Repeated arterial infusion chemotherapy for inoperable hepatocellular carcinoma using an implantable drug delivery system. Cancer Chemother Pharmacol. 1994;33:S134–8.CrossRefPubMed Iwamiya T, Sawada S, Ohta Y. Repeated arterial infusion chemotherapy for inoperable hepatocellular carcinoma using an implantable drug delivery system. Cancer Chemother Pharmacol. 1994;33:S134–8.CrossRefPubMed
20.
Zurück zum Zitat Llovet JM, Sala M, Castells L, et al. Randomized controlled trial of interferon treatment for advanced hepatocellular carcinoma. Hepatology. 2000;31:54–8.CrossRefPubMed Llovet JM, Sala M, Castells L, et al. Randomized controlled trial of interferon treatment for advanced hepatocellular carcinoma. Hepatology. 2000;31:54–8.CrossRefPubMed
21.
Zurück zum Zitat Wadler S, Schwartz EL. Antineoplastic activity of the combination of interferon and cytotoxic agents against experimental and human malignancies: a review. Cancer Res. 1990;50:3473–86.PubMed Wadler S, Schwartz EL. Antineoplastic activity of the combination of interferon and cytotoxic agents against experimental and human malignancies: a review. Cancer Res. 1990;50:3473–86.PubMed
22.
Zurück zum Zitat Chung YH, Song IH, Song BC, et al. Combined therapy consisting of intraarterial cisplatin infusion and systemic interferon-(for hepatocellular carcinoma patients with major portal vein thrombosis or distant metastasis. Cancer. 2000;88:1986–91.CrossRefPubMed Chung YH, Song IH, Song BC, et al. Combined therapy consisting of intraarterial cisplatin infusion and systemic interferon-(for hepatocellular carcinoma patients with major portal vein thrombosis or distant metastasis. Cancer. 2000;88:1986–91.CrossRefPubMed
23.
Zurück zum Zitat Patt YZ, Hassan MM, Lozano RD, et al. Phase II trial of systemic continuous fluorouracil and subcutaneous recombinant interferon alfa-2b for treatment of hepatocellular carcinoma. J Clin Oncol. 2003;21:421–7.CrossRefPubMed Patt YZ, Hassan MM, Lozano RD, et al. Phase II trial of systemic continuous fluorouracil and subcutaneous recombinant interferon alfa-2b for treatment of hepatocellular carcinoma. J Clin Oncol. 2003;21:421–7.CrossRefPubMed
24.
Zurück zum Zitat Yano H, Iemura A, Haramaki M, et al. Interferon alfa receptor expression and growth inhibition by interferon alpha in human liver cell lines. Hepatology. 1999;29:1708–17.CrossRefPubMed Yano H, Iemura A, Haramaki M, et al. Interferon alfa receptor expression and growth inhibition by interferon alpha in human liver cell lines. Hepatology. 1999;29:1708–17.CrossRefPubMed
Metadaten
Titel
Arterial infusion of 5-fluorouracil combined with subcutaneous injection of pegylated interferon alpha-2b in treating unresectable hepatocellular carcinoma with portal vein tumor thrombus
verfasst von
Jian Wu
Wen-Jin Huang
Huan-Yu Wang
Ya-Feng Wang
Bao-Gang Peng
Qi Zhou
Publikationsdatum
01.03.2015
Verlag
Springer US
Erschienen in
Medical Oncology / Ausgabe 3/2015
Print ISSN: 1357-0560
Elektronische ISSN: 1559-131X
DOI
https://doi.org/10.1007/s12032-015-0491-4

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