ADJUVANT THERAPY WITH ESSENTIAL FATTY-ACIDS (EFAS) FOR PRIMARY LIVER-TUMORS - SOME HYPOTHESES

Hepatocarcinoma is responsible for approximately 1 million deaths annu ally It is usually discovered at an advanced stage and, if inoperable, has a poor prognosis. New therapies combining chemotherapy, hyperther mia, radiotherapy and immunomodulators have been recently attempted wi th various levels of success. Once the tumor is detected at an early s tage, some possibilities of cure seem to emerge either by intratumoral percutaneous injection (PEI) of alcohol or by chemoembolization and i nterstitial hyperthermia. When the tumor volume is more than 5cm, thes e therapies are less successful and radiotherapy can be used. AH the t echniques described have some limits; PEI, for instance, does not achi eve a complete eradication of lesions >3cm and a non-homogenous alcoho l distribution within the tumor leads to areas of necrosis. Radiothera py, even if effective, is limited by dose-related radiation hepatitis. Another important limiting factor is the incomplete response to thera py and tumor recurrence. Essential fatty acids, especially gamma linol enic acid (GLA) and eicosapentaenoic acid (EPA) are discussed here for their ability to control primary tumor proliferation and increase res ponse to chemotherapy, radiotherapy and hyperthermic treatment, thanks to their effects on cellular membranes (increased lipoperoxidation an d modification of tumor stroma).