OBJECTIVETo investigate the effects of pentoxifylline (PTX) on radiation induced-cell cycle redistribution and radiosensitivity of human hepatocellular carcinoma cell line Hep3b.

METHODSMTT assay was performed to evaluate the cytotoxicity of PTX on p53-defective human hepatocellular carcinoma cell line Hep3b and clonogenic assay employed to observe its effects on the radiosensitivity of the cells quantified by calculating the sensitive enhancement ratio (SER). Flow cytometry was performed to observe the cell cycle changes of Hep3b cells in response to X-ray irradiation and the interventional effect of PTX.

RESULTSThe cytotoxicity of PTX on the cells increased in a dose-dependent manner following a 48-hour treatment, with the optimal dose range of 1-5 mmol/L. A sub-toxic dose of PTX at 2 mmol/L was then used in subsequent experiments. Clonogenic survival assays up to 12 Gy demonstrated that p53-defective Hep3b cells (SER of 2.68+/-0.24) were sensitized by PTX (2 mmol/L). PTX (2 mmol/L) treatment following exposure to irradiation (6 Gy) resulted in abrogation of radiation-induced G(2)/M arrest of Hep3b cells, and the proportions of Hep3b cells in G(2)/M phase were 86.8% and 14.8% after exposure to 6 Gy alone and 6 Gy plus 2 mmol/L PTX, respectively.

CONCLUSIONRadiosensitization by PTX is possibly associated with the abrogation of G(2)/M arrest in Hep3b cells following radiation exposure, suggesting that potential clinical application of PTX may enhance the efficacy of radiotherapy against hepatocellular carcinoma.

Carcinoma, Hepatocellular ; drug therapy ; pathology ; radiotherapy ; Cell Cycle ; drug effects ; radiation effects ; Cell Line, Tumor ; Cell Survival ; drug effects ; radiation effects ; Combined Modality Therapy ; Dose-Response Relationship, Drug ; Dose-Response Relationship, Radiation ; Humans ; Liver Neoplasms ; drug therapy ; pathology ; radiotherapy ; Pentoxifylline ; pharmacology ; Radiation-Sensitizing Agents ; pharmacology ; X-Rays

PURPOSE: Sorafenib is an effective systemic agent for advanced hepatocellular carcinoma. To increase its efficacy, we evaluated the feasibility and benefit of sorafenib combined with radiotherapy. MATERIALS AND METHODS: From July 2007 to July 2011, 31 patients were treated with a daily dose of 800 mg of sorafenib and radiotherapy. Among them, 13 patients who received radiotherapy on the bone metastasis were excluded. Thirteen patients received 30-54 Gy of radiotherapy on the primary tumor (primary group) and 5 patients received 30-58.4 Gy on the measurable metastatic lesions (measurable metastasis group). Tumor responses at 1 month after the completion of radiotherapy and overall survival were evaluated. RESULTS: The in-field response rate was 100% in the primary group and 60% in the measurable metastasis group. A decrease of more than 80% in the tumor marker alpha-fetoprotein was observed in 7 patients in the primary group (54%). Toxicities of grades 3-4 were hand-foot syndrome in 3 (17%) patients, duodenal bleeding in 1 (6%) patient, thrombocytopenia in 3 (17%) patients and elevation of aspartate transaminase in 1 (6%) patient. The median overall survival was 7.8 months (95% confidence interval, 3.0-12.6). CONCLUSION: The combined treatment of sorafenib and radiotherapy was feasible and induced substantial tumor responses in the target lesions. The results of this study emphasize the importance of individualized approach in the management of advanced hepatocellular carcinoma and encourage the initiation of a controlled clinical trial.
Antineoplastic Agents/administration & dosage/adverse effects/*therapeutic use ; Carcinoma, Hepatocellular/drug therapy/pathology/*radiotherapy ; Chemotherapy, Adjuvant ; Feasibility Studies ; Female ; Humans ; Liver Neoplasms/drug therapy/pathology/*radiotherapy ; Male ; Niacinamide/administration & dosage/adverse effects/*analogs & derivatives/therapeutic use ; Phenylurea Compounds/administration & dosage/adverse effects/*therapeutic use ; Radiation Dosage ; Radiotherapy/adverse effects

Hepatitis C virus (HCV) is one of the main viral causes of hepatocellular carcinoma (HCC) and is associated with lymphoproliferative disorder such as non-Hodgkin's lymphoma (NHL). However, there are only few case reports on concomitantly induced NHL and HCC by HCV. Herein, we report a case of synchronous NHL and HCC in a patient with chronic hepatitis C which was unexpectedly diagnosed during liver transplantation surgery. This case suggests that although intrahepatic lymph node enlargements are often considered as reactive or metastatic lymphadenopathy in chronic hepatitis C patients with HCC, NHL should also be considered as a differential diagnosis.
Antineoplastic Agents/therapeutic use ; Carcinoma, Hepatocellular/complications/*diagnosis/radiotherapy ; Drug Therapy, Combination ; Embolization, Therapeutic ; Fluorodeoxyglucose F18 ; Gadolinium DTPA ; Genotype ; Hepatitis B virus/genetics ; Hepatitis C, Chronic/complications/*diagnosis/*virology ; Humans ; Liver Neoplasms/complications/*diagnosis/radiotherapy ; Lymph Nodes/pathology ; Lymphoma, Non-Hodgkin/complications/*diagnosis/drug therapy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Positron-Emission Tomography ; Tomography, X-Ray Computed