INTRAARTERIAL CHEMOTHERAPY FOLLOWED BY CHEMOEMBOLIZATION IN UNRESECTABLE HEPATOCELLULAR-CARCINOMA

Unresectable hepatocellular carcinoma is related to a poor prognosis. Encouraging response rates and survival have been reported with intra- arterial (i.a.) chemotherapy and chemo-embolisation, but limited data are available on the association of the two treatment modalities. We t herefore started a new programme combining i.a. chemotherapy with chem o-embolisation. The treatment regimen consisted of L-leucovorin (100 m g/m(2) i.v.), 5-fluorouracil (800 mg/m(2) i.a.), and carboplatin (250 mg/m(2) i.a.). Chemo-embolisation with mitoxantrone (10 mg/m(2)) plus ethiodized oil followed immediately. The same treatment plus gelatin s ponge was given after 28 days. 26 patients entered the study and were evaluable for response and side-effects. Main patient characteristics were: males 21, females 5: median age 68 years (range 42-76 years); st age TNM II-III 17, IVA 9; Child's A 12, Child's B 14; elevated baselin e cr-fetoprotein 17; cirrhosis 25. 14 patients had a partial response (54%; 95% confidence interval 33-73%), 3 had stabilisation and 9 had p rogressive disease. Median survival was II months (range 2-20+). 16 pa tients had, grade I-II pain and 15 grade I-II fever. Our results indic ate that the regimen is safe, well tolerated and capable of inducing o bjective remissions in a high percentage of patients with hepatocellul ar carcinoma. (C) 1997 Elsevier Science Ltd.