COMBINED TRANSARTERIAL TARGETING LOCOREGIONAL IMMUNOTHERAPY-CHEMOTHERAPY FOR PATIENTS WITH UNRESECTABLE HEPATOCELLULAR-CARCINOMA - A NEW ALTERNATIVE FOR AN OLD PROBLEM

The prognosis for patients with advanced (stage III and IV) hepatocell ular carcinoma (HCC) remains poor, Liver resection and liver transplan tation have limited effects on overall survival. Our study was carried out to assess a novel therapeutic approach, which includes transarter ial locoregional chemotherapy and in vivo locoregional dual immunostim ulation, in patients with unresectable HCC. A group of 20 patients wit h stage III and IV hepatocellular carcinoma had 10 courses (once per d ay) of transarterial targeted locoregional immunotherapy with interfer on-gamma (IFN-gamma) and interleukin-2 (IL-2), emulsified in a Lipiodo l-Urografin mixture. The target organs were the spleen and the liver t umor itself. One course of intrahepatic locoregional targeting transar terial chemotherapy was given 10 days after completion of immunotherap y (mitomycin C, carboplatin, Farmorubicin, Leucovorin, 5-fluorouracil, and IFN-gamma). This was followed after 2 months by another course of transarterial targeted locoregional immunotherapy-chemotherapy. All p atients survived the operation and had a mean survival time of 18 mont hs (4-22 months). There was a decrease in the tumor size of 14 of the 20 patients. Serum alpha-fetoprotein (AFP) levels declined in 14 patie nts, reaching normal levels in 12 patients. These preliminary results indicate that combined locoregional immunotherapy-chemotherapy is a pr omising therapeutic approach in patients suffering from advanced nonre sectable HCC and merits further evaluation.