INTRAHEPATIC ARTERIAL I-131 ANTI-HEPATOCELLULAR CARCINOMA (HCC) MONOCLONAL-ANTIBODY COMBINED WITH HEPATIC-ARTERY LIGATION FOR TREATMENT OF UNRESECTABLE HCC

Cytoreduction and sequential resection has provided a new hope for pat ients with unresectable hepatocellular carcinoma (HCC), but a small pr oportion of patients have an opportunity for receiving sequential rese ction. The muitimodality therapy, especially combined with radioimmuno therapy (RAIT), has resulted in better shrinkage of tumor and increase d sequential resection rate. Thirty-two patients with surgically verif ied unresectable HCC have been treated by intrahepatic arterial admini stration of I-131 anti-HCC monoclonal antibody (Hepama-1 MoAb) combine d with hepatic artery ligation. No other treatments were added. Radioi mmunoimaging demonstrated that the median tumor/liver ratio was 1.7 at day 5 and increased with the passage of time. Reduction of tumor was observed in 72% (23/32) of patients. After RAIT, sequential resection was performed in 17 patients (53%). The surgical specimens revealed ma ssive necrosis of tumor, but residual cancer cells were found in some specimens. Human anti-murine antibody (HAMA) was determined in 34% (11 /32) of patients within 2-4 weeks post-infusion. No marked toxic effec ts were noted. It is suggested that intra-hepatic arterial I-131 Hepam a-1 MoAb is one of the acceptable methods of multimodality treatment f or unresectable HCC. Sequential resection is needed to eradicate resid ual cancer when remarkable tumor shrinkage is achieved.