Systemic chemotherapy with epirubicin for treatment of advanced or multifocal hepatocellular carcinoma

Background: The purpose of this retrospective study was to determine the re sponse rate and effect on survival of chemotherapy with epirubicin in non-r esectable advanced hepatocellular carcinoma (HCC). Methods: Fifty-two patie nts with non-resectable disease were treated with epirubicin. A treatment c ycle consisted of 20 mg/m(2) i.v. on days 1, 8 and 15 and was repeated ever y 4 weeks to a maximum dose of 1,000 mg/m(2). Forty-four patients were elig ible for analysis. Results: Out of 44 patients, 1 (2.3%) achieved a complet e response, 3 (6.8%) had partial responses and 16 (36%) had stable disease (SD). For patients with successful disease control (complete and partial re sponders and patients with SD), the median survival was 16.2 months; for no n-responders, it was 6.1 months (p < 0.003). Eight (88.9%) of 9 patients wi th alpha-fetoprotein (AFP) levels < 50 mug/l achieved successful disease co ntrol compared to 12 (34.9%) out of 35 patients with initially elevated AFP (p < 0.0001). Conclusion: Epirubicin appears to be an active therapeutic o ption for patients with nonresectable HCC. Especially the subgroup of patie nts with low levels of AFP may benefit from this treatment. Copyright (C) 2 001 S. Karger AG, Basel.