A PROSPECTIVE RANDOMIZED ADMINISTRATION OF 5'-DEOXY-5-FLUOROURIDINE AS ADJUVANT CHEMOTHERAPY FOR HEPATOCELLULAR-CARCINOMA TREATED WITH TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION
K. Ikeda et al., A PROSPECTIVE RANDOMIZED ADMINISTRATION OF 5'-DEOXY-5-FLUOROURIDINE AS ADJUVANT CHEMOTHERAPY FOR HEPATOCELLULAR-CARCINOMA TREATED WITH TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION, American journal of clinical oncology, 20(2), 1997, pp. 202-208
A prospective randomized trial was conducted to evaluate the efficacy
of long-term oral administration of low-dose 5'-deoxy-5-fluorouridine
(5'-DFUR) as an adjuvant chemotherapy, following transcatheter arteria
l embolization (TAE) in 40 patients with hepatocellular carcinoma (HCC
). Forty eligible patients were randomized into two groups: 20 with TA
E plus 5'-DFUR (400 mg/day) and 20 with TAE alone. A good necrosis rat
e or decrease in size of more than 70% of the original tumor mass was
attained in 14 by the TAE plus 5'-DFUR arm, and in 12 by the TAE arm a
t 3 months after the first TAE. Although all five patients with HCC an
d 70-99% necrosis rate after the first TAE in the TAE alone arm showed
a less than 70% necrosis rate at 12 months, four of the seven patient
s with a 70-99% necrosis in the TAE plus 5'-DFUR arm retained a necros
is of more than 70% at 12 months after the first TAE. The appearance r
ate of ascites and/or encephalopathy in patients with chemotherapy was
not different from that of patients with TAE alone. One-year survival
rates in the TAE plus 5'-DFUR arm and the TAE alone arm were 75.0% an
d 85.0%, 2-year rates were 64.2% and 66.2%, and 3-year rates were 64.6
% and 49.7%, respectively. There was no significant difference in the
survival curves. In conclusion, adjuvant therapy with 5'-DFUR was well
tolerated without significant side effects, and it might maintain a g
ood necrosis state of HCC after TAE. In order to confirm a beneficial
effect of the chemotherapy on the survival period, a study using more
patients and longer observation periods will be required.