Hepatic arterial infusion chemotherapy with continuous low dose administration of cisplatin and 5-fluorouracil for multiple recurrence of hepatocellular carcinoma after surgical treatment.

Okuda, K; Tanaka, Masaya; Shibata, J; Ando, Eiji; Ogata, Tetsuya; Kinoshita, Hisafumi; Eriguchi, Naofumi; Aoyagi, Shigeaki; Tanikawa, Kyuichi

doi:10.3892/or.6.3.587

Cited by 48 publications

(46 citation statements)

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“…There is a growing discussion about whether HAIC or molecular targeted therapy should be selected as the first-line treatment for patients with HCC who are not eligible for TACE, such as with major vascular invasion, and multiple HCCs unresponsive to TACE. For such cases, HAIC generally provides good outcomes with a RR of between 14-71% and an MST of 2.6-15.9 months [23,35,43]. The RR of HAIC in our study was similar to that of previous reports, where the responders demonstrated a better outcome than non-responders.…”

Section: Discussionsupporting

confidence: 81%

Phase I/II Study of Sorafenib in Combination with Hepatic Arterial Infusion Chemotherapy Using Low-Dose Cisplatin and 5-Fluorouracil

et al. 2015

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We conducted a phase I/II study in patients with advanced hepatocellular carcinoma (HCC) to determine the recommended dose, as well as the safety and efficacy, of combination therapy of sorafenib with hepatic arterial infusion chemotherapy (HAIC) using low dose cisplatin (CDDP) and 5-fluorouracil (5FU). Cohorts consisting of 3-6 patients with HCC received an escalated dose of CDDP and 5-FU until a maximum-tolerated dose was achieved. The treatment regimen was as follows: oral administration of sorafenib (400 mg twice daily for 28 days) combined with HAIC using CDDP (14-20 mg/m², on days 1 and 8) and 5-FU (170-330 mg/m², continuously on days 1-5 and 8-12) via an implanted catheter system). Each treatment cycle consisted of 28 days and three cycles of combination therapy. At the end of the first cycle, adverse events were evaluated and future dose escalation was determined. Eighteen patients with advanced HCC were enrolled. Dose-limiting toxicity was observed in two patients from cohort 1 (erythema multiforme and grade 4 thrombocytopenia) and in one patient from cohort 2 (erythema multiforme). Seven of the 18 patients achieved a partial response, seven showed stable disease, two were diagnosed as progressive disease, and two were not assessable. The response rate was 38.9% and the disease control rate was 77.8%. The time-to-progression was 9.7 months and the 1-year survival rate was 88.2%. Oral administration of 400 mg of sorafenib twice daily, 20 mg/m² of intra-arterial infusion of CDDP, and 5-FU at 330 mg/m² are the recommended doses for combination therapy, which was well tolerated and efficacious. This combination therapy may be a promising treatment for patients with advanced HCC. A large prospective randomized multicenter study (ClinicalTrials.gov Identifier NCT01214343) is ongoing.

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Section: Discussionsupporting

confidence: 81%

Phase I/II Study of Sorafenib in Combination with Hepatic Arterial Infusion Chemotherapy Using Low-Dose Cisplatin and 5-Fluorouracil

et al. 2015

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“…In Japan, HAI chemotherapy with the continuous low-dose administration of CDDP and 5-FU (low-dose FP) (12) is frequently used to treat advanced, unresectable and multinodular forms of hepatocellular carcinoma (HCC). HAI with low-dose FP achieved more beneficial therapeutic results for these HCCs than transcatheter arterial chemoembolization (13,14). In addition to its own effect, CDDP amplifies the cell-killing effect of 5-FU, and the combination of CDDP and 5-FU, is widely used in chemotherapy for esophageal, colorectal and ovarian carcinomas.…”

Section: Discussionmentioning

confidence: 99%

A successful treatment for metastatic liver tumors from endocrine carcinoma of the stomach

Nishimura¹,

Fujiyama²

2007

Oncol Rep

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Abstract. Endocrine carcinomas (ECs) of the stomach reveal prominently aggressive behavior and have poor prognoses. Optimal treatments for gastric ECs have not been established because of the rarity of EC. In general, patients with gastric ECs die within a year of diagnosis in spite of surgical resections and subsequent chemotherapies. Liver metastases are the most common cause of death in gastric ECs, and their control is very important for improving the poor prognosis associated with the disease. In the present report, we describe a case in which a subject with stomach EC was diagnosed at an early stage. However, multiple liver metastases occurred soon after curative surgical resection and were treated via hepatic arterial infusion (HAI) with a combination of cisplatin and 5-fluorouracil. Consequently, the tumors almost completely disappeared. HAI therapy is a useful treatment for multiple metastatic liver tumors from gastric ECs devoid of metastases in other organs. Previously published therapies used to treat ECs of the stomach, including the ones used in the current case, are also discussed herein.

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“…It was reported that improvement of implanted drug delivery systems has made it possible to administer repeated hepatic arterial infusion of anticancer agents to patients with aHCC and that hepatic arterial infusion therapy not only improved survival but also the quality of life (QOL) [2] . Continuous local arterial infusion of 5-fluorouracil (5-FU) and cisplatin (CDDP) using an infuser pump and an implanted reservoir has been shown to prolong the survival of patients with severe advanced HCC [2][3][4] . Leucovorin is a biochemical modulator of 5-FU [5][6][7] .…”

Section: Introductionmentioning

confidence: 99%

Twenty-four hour intra-arterial infusion of 5-fluorouracil, cisplatin, and leucovorin is more effective than 6-hour infusion for advanced hepatocellular carcinoma

Nagai

Kanayama²,

Higami³

et al. 2007

WJG

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AIM:To evaluate the time dependence of intra-arterial 5-fluorouracil (5-FU) therapy for advanced hepatocellular carcinoma (aHCC). METHODS:Thirty-seven adult Japanese patients who had aHCC and liver cirrhosis were treated with combined intra-arterial 5-FU, cisplatin (CDDP), and leucovorin (LV). The Japan Integrated Staging score (JIS score) of each patient was 3 or more. The patients were divided into two groups, after which the 15 patients in group S were treated with 6-h infusion chemotherapy (LV at 12 mg/h, CDDP at 10 mg/h, and 5-FU at 250 mg/m 2 per 4 h) and the 22 patients in group L were treated with 24-h infusion chemotherapy (LV at 12 mg/h, CDDP at 10 mg/h, and 5-FU at 250 mg/m 2 per 22 h). Continuous infusion chemotherapy was performed via the proper hepatic artery every 5 d for 4 wk using an implanted drug reservoir. RESULTS:The percentages of patients with a partial response after 4 wk of chemotherapy were 6.7% in group S and 31.8% in group L. The survival of group L was significantly better than that of group S, with the median survival time being 496 d in group L and 226 d in group S (P < 0.05). CONCLUSION:Continuous 24-h intra-arterial infusion is more effective for aHCC and can markedly prolong survival time as compared to 6-h infusion.

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Hepatic arterial infusion chemotherapy with continuous low dose administration of cisplatin and 5-fluorouracil for multiple recurrence of hepatocellular carcinoma after surgical treatment.

Cited by 48 publications

References 0 publications

Phase I/II Study of Sorafenib in Combination with Hepatic Arterial Infusion Chemotherapy Using Low-Dose Cisplatin and 5-Fluorouracil

Phase I/II Study of Sorafenib in Combination with Hepatic Arterial Infusion Chemotherapy Using Low-Dose Cisplatin and 5-Fluorouracil

A successful treatment for metastatic liver tumors from endocrine carcinoma of the stomach

Twenty-four hour intra-arterial infusion of 5-fluorouracil, cisplatin, and leucovorin is more effective than 6-hour infusion for advanced hepatocellular carcinoma

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