Chemoembolization of hepatocellular carcinoma with cisplatin, doxorubicin,mitomycin-C, ethiodol and polyvinyl alcohol: Prospective evaluation of response and survival in a US population

PURPOSE: To evaluate response and survival after hepatic chemoembolization with cisplatin, doxorubicin, mitomycin-C, Ethiodol, and polyvinyl alcohol i n a U.S. population of patients with hepatocellular carcinoma, MATERIALS AND METHODS: Thirty-eight consecutive patients were treated: 35% stage I, 62% stage II, 3% stage III, Fifty-one percent had cirrhosis, Chemo embolization was performed at approximately monthly intervals for one to se ven sessions (mean, 2.2), Pretreatment and posttreatment cross-sectional im aging and alphafetoprotein (AFP) levels were obtained prospectively 1 month after treatment and then every 3 months. Thirty-day response was calculate d by means of the the World Health Organization/Eastern Cooperative Oncolog y Group criteria. RESULTS: One patient was lost to follow-up. In seven patients, lesions beca me resectable after chemoembolization. Among 13 evaluable patients with ini tially elevated AFP level, 70% had a partial biologic response (>50% decrea se in AFP), 15% had a minor response (25-50% decrease), and the remaining 1 5% remained stable. Among 25 patients evaluable for morphologic response, 3 6% had a partial response, 32% had a minor response, and 32% remained stabl e, No patients had progression of disease while receiving therapy, The cumu lative survival was 60% at 1 year, 41% at 2 years, and 16% at 3 years. Two patients developed progressive hepatic failure, Thirty-day mortality was 3% (one patient). CONCLUSION: These results compare favorably to published response and survi val data for chemoembolization of advanced hepatocellular carcinoma fr om A sia and Europe.