No abstract available.
Carcinoma, Hepatocellular* ; Drug Therapy*

Hepatocellular carcinomas are one of the most common malignancies in the world. However, no effective therapeutic modality has been proven to prolong the survival of patients in an inoperable stage. The purpose of this study was to determine the response rate and the toxicities of a combination of pirarubicin, UFT and leucovorin in patients with non-embolizable hepatocellular carcinomas, or who had progressed during their transcatheter arterial chemoembolization treatment. MATERIALS AND METHODS: Of 23 patients with a hepatocellular carcinoma, 11 had progressed during a transcatheter arterial chemoembolization, with the other 12 being transcatheter arterial chemoembolization-naive. All the patients were treated with pirarubicin (70 mg/m2 i.v., day 1), UFT (350 mg/m2 P.O., day 1~21), and leucovorin (25 mg/m2 P.O., day 1~21). RESULTS: Twenty patients were able to be evaluated, with a partial response being achieved in four, giving an overall response rate of 20% (95% confidence interval, 7~44%). The median overall survival time was 6 months, and the median survival time of the transcatheter arterial chemoembolization-naive patients was significantly longer than that of those treated by transcatheter arterial chemoembolization (p=0.012). The most significant dose-limiting toxicity was leucopenia and thrombocytopenia. CONCLUSION: The combination of pirarubicin, UFT and leucovorin therapies showed marginal antitumor activity and significant toxicity in patients with non-embolizable or failed transcatheter arterial chemoembolization hepatocellular carcinomas.
Carcinoma, Hepatocellular* ; Drug Therapy* ; Humans ; Leucovorin* ; Thrombocytopenia

Cholangiocarcinoma is the most common biliary malignancy and the second most common hepatic malignancy following hepatocellular carcinoma. It can be classified anatomically as intrahepatic cholangiocarcinoma (iCCA), perihilar CCA, or distal CCA. The treatment of choice for iCCA is surgical resection, but only those with potentially resectable tumors can undergo surgery. The standard regimen for advanced stage iCCA is gemcitabine and cisplatin. We encountered two unusual cases of iCCA patients who were initially diagnosed as unresectable cases and underwent systemic chemotherapy, which showed great response and therefore enabled radical operation. The patients show that even though iCCA is a challenging disease, patients with good response to chemotherapy may have a chance to undergo radical surgery.
Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Cisplatin ; Drug Therapy ; Humans

Carcinoma, Hepatocellular ; drug therapy ; Humans ; Liver Neoplasms ; drug therapy

Sorafenib is the standard treatment for advanced hepatocellular carcinoma according to the Barcelona Clinic Liver Cancer staging system. However, because of its unsatisfactory efficacy, adverse effects, and high cost, the use of sorafenib is limited, and other treatment modalities are required. Recent studies reported that treatment modalities other than sorafenib, such as hepatic arterial infusion chemotherapy and transarterial radioembolization, showed comparable or better response rates and survival rates than sorafenib. In this review, treatment modalities that could be used as alternatives to sorafenib will be discussed.
Carcinoma, Hepatocellular* ; Drug Therapy ; Humans ; Liver Neoplasms ; Survival Rate

Transcatheter arterial chemoembolization(TACE) is an imperative method for the managment of inoperable hepatocellular carcinoma(HCC). It is well known that primary HCC frequently invades the portal venous system and forms a tumor thrombus obstructing the portal blood flow which makes unfavorable prognosis of patiebt. We retrospetively reviewed 58 patients who reveived TACE(minimum 3 times) of HCC invading into portal venous system. Group 1(n=29) which showed peripheral portal vein invasion had better clinical and laboratory response. Group 2(n=17) which showed first order portal branch invasion had similar response to Group 3(n=12), which had main portal invasion. Group 1 showed no difference in survival time between TAC and TACE, but, in Group 2 and 3, emboliation with chemotherapy made longer survival than chemotherapy only. Clinical level of AFP was meaningful in Group 1 and 2 as decreasing value. Our results provides that careful selection of TACE and case by case Coil/Gelfoam embolization can improve the mean survival and clinical response when HCC evidently invades portal venous system.
Carcinoma, Hepatocellular* ; Drug Therapy ; Humans ; Methods ; Portal Vein* ; Prognosis ; Thrombosis

Transcatheter arterial chemoembolization(TACE) is an imperative method for the managment of inoperable hepatocellular carcinoma(HCC). It is well known that primary HCC frequently invades the portal venous system and forms a tumor thrombus obstructing the portal blood flow which makes unfavorable prognosis of patiebt. We retrospetively reviewed 58 patients who reveived TACE(minimum 3 times) of HCC invading into portal venous system. Group 1(n=29) which showed peripheral portal vein invasion had better clinical and laboratory response. Group 2(n=17) which showed first order portal branch invasion had similar response to Group 3(n=12), which had main portal invasion. Group 1 showed no difference in survival time between TAC and TACE, but, in Group 2 and 3, emboliation with chemotherapy made longer survival than chemotherapy only. Clinical level of AFP was meaningful in Group 1 and 2 as decreasing value. Our results provides that careful selection of TACE and case by case Coil/Gelfoam embolization can improve the mean survival and clinical response when HCC evidently invades portal venous system.
Carcinoma, Hepatocellular* ; Drug Therapy ; Humans ; Methods ; Portal Vein* ; Prognosis ; Thrombosis

Biological Therapy ; Carcinoma, Hepatocellular ; drug therapy ; radiotherapy ; therapy ; Humans ; Liver Neoplasms ; drug therapy ; radiotherapy ; therapy ; Radiography, Interventional ; Ultrasonic Therapy

Carcinoma, Hepatocellular ; drug therapy ; Humans ; Interferon-alpha ; therapeutic use ; Liver Neoplasms ; drug therapy

PURPOSE: Hepatocellular carcinoma (HCC) is the most common form of primary hepatic carcinoma and is considered to be a highly malignant tumor with poor prognosis. We evaluated the efficacy and toxicities of AP (doxorubicin, cisplatin) comnination chemotherapy in hepatocellular carcinoma. MATERIALS AND METHODS: Between October 1989 and February 1991, 21 previously untreated patients with advanced hepatocellular carcinoma were entered and treated with AP combination chemotherapy (adriamycin 60 mg/m2, D1 and cisplatin 60 mg/m2, D1, repeated every 3 weeks). RESULTS: Among 14 evaluable patients, there was no complete response and 5 patients (36%; 95% C.I=10~62%) achieved partial response. The median survival time of all 21 patients was 17 weeks, and 63 weeks in responders (n=5) and 14 weeks in nonresponders (n=16), and the difference in two groups was statistically significant (p<0.05). The median time to progression of 14 evaluable patients was 13 weeks, and 49 weeks in the responders (n=5) and 6 weeks in the nonresponders (n=9), and the difference in two groups was statistically significant (p<0.05). Myelosuppression was minimal and non-hematologic toxicities were gererally mild and well tolerated. CONCLUSION: The results suggest that the combination chemotherpy of AP seems to be an effective regimen for hepatocellular carcinoma. Further trials are recommended for its true efficacy.
Carcinoma, Hepatocellular* ; Cisplatin ; Doxorubicin ; Drug Therapy* ; Drug Therapy, Combination ; Humans ; Prognosis