Quadruple chemotherapy versus radiotherapy in treatment of primary hepatocellular carcinoma

Abstract

Although there have been many therapeutic trials of chemotherapy for primary hepatoma, few have been controlled and the results of treatment have been disappointing. The present report is concerned with a controlled trial of chemotherapy alone versus radiotherapy followed by chemotherapy in 18 patients with primary hepatoma. Ten patients received quadruple chemotherapy (5-flurouracil, cyclophosphamide, methotrerate, and vincristine). These patients survived considerably longer (21 weeks) than eight patients who received radiotherapy followed by the same chemotherapy regime (12 weeks). Further analysis of these results suggested that length of survival in both treatment groups was related to age, length of history, levels of serum bilirubin and aspartate transaminase, and to the presence of cirrhosis or ascites. According to these criteria, patients were subdivided into two grades of disease. For patients with less severe disease (grade A), median survival after chemotherapy alone (54 weeks) was longer than after radiotherapy followed by chemotherapy (24 weeks). Survival of patients with severe disease (grade B) was equally poor in both treatment groups (5 weeks, chemotherapy; 7 5 weeks radiotherapy followed by chemotherapy). In conclusion, these results show that quadruple chemotherapy alone is a valuable form of therapy for grade A patients. Neither form of therapy, however, was of any benefit for grade B patients. is unfortunately applicable to only a minority of patients, as both lobes of the liver are so frequently involved. This is also not possible in the presence of cirrhosis, which is found in

Stereotactic Body Radiotherapy for Patients With Unresectable Primary Hepatocellular Carcinoma: Dose-Volumetric Parameters Predicting the Hepatic Complication

“…RT has not been widely used for the treatment of HCC because of the low tolerable dose of radiation for the entire liver, which was not effective for the tumor control (8)(9)(10).…”

Radiation therapy for intrahepatic recurrence after hepatectomy for hepatocellular carcinoma

“…The results of whole liver RT have been poor, with high toxicity and low efficacy regarding patient survival. 18 Alternatively, RT confined to the abnormal area is feasible. Although the response rate depends on such factors as dose, tumor size, and additional therapy, the response was reported to be 63.3%-70.5%.…”

Significance of an increase in the Child-Pugh score after radiotherapy in patients with unresectable hepatocellular carcinoma

“…Previously, RT was not widely used because the whole liver could only tolerate low levels of radiation, and these low doses were insufficient to effectively control tumors [4,5]. However, recent studies have shown that partial volume irradiation is both feasible and effective for tumor control with an acceptable range of hepatic toxicity [6-8].…”