Intra-arterial 5-fluorouracil/interferon combination therapy for advanced hepatocellular carcinoma with or without three-dimensional conformal radiotherapy for portal vein tumor thrombosis

被引:66
作者
Katamura, Yoshio [1 ]
Aikata, Hiroshi [1 ]
Takaki, Shintaro [1 ]
Azakami, Takahiro [1 ]
Kawaoka, Tomokazu [1 ]
Waki, Koji [1 ]
Hiramatsu, Akira [1 ]
Kawakami, Yoshiiku [1 ]
Takahashi, Shoichi [1 ]
Kenjo, Masahiro [2 ]
Toyota, Naoyuki [3 ]
Ito, Katsuhide [3 ]
Chayama, Kazuaki [1 ]
机构
[1] Hiroshima Univ, Grad Sch Biomed Sci, Dept Med & Mol Sci, Programs Biomed Res,Div Frontier Med Sci,Minami K, Hiroshima 7348551, Japan
[2] Hiroshima Univ Hosp, Div Radiat Oncol, Hiroshima, Japan
[3] Hiroshima Univ, Dept Radiol, Hiroshima, Japan
关键词
Hepatocellular carcinoma; Portal vein tumor thrombosis; Radiotherapy; 5-FU; IFN; TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION; SUBCUTANEOUS INTERFERON-ALPHA; INFUSION CHEMOTHERAPY; LOCAL RADIOTHERAPY; NATURAL-HISTORY; CANCER; TRIAL; CISPLATIN; PROGRESSION; INHIBITION;
D O I
10.1007/s00535-009-0033-y
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
The aim of this study was to elucidate the efficacy of intra-arterial 5-fluorouracil (5-FU) and interferon (IFN) alpha combined with three-dimensional conformal radiotherapy (3D-CRT) for portal vein tumor thrombosis (PVTT). The study groups were 16 HCC patients with PVTT treated with 5-FU/IFN combined with 3D-CRT (RT group) and 16 matched controls treated with 5-FU/IFN alone (non-RT group). We compared the survival rate, response, time to progression (TTP), portal hypertension-related events (PREs) and safety. Complete response (CR) of PVTT, partial response (PR), stable disease (SD) and progressive disease (PR) were noted in three (19%), nine (56%), four (25%) and zero patients of the RT group, one (6%), three (19%), seven (44%) and five (31%) patients of the non-RT group, respectively. The objective response rate of PVTT was higher in the RT group (P = 0.012). The rate of PREs (variceal rupture, worsening of esophagogastric varices and emerging of uncontrollable ascites) was lower in the RT group than in the non-RT group (P = 0.0195). The median survival time of the RT group (7.5 months) was not significantly different from that of the non-RT group (7.9 months). RT-induced liver disease was not observed. 5-FU/IFN combination with 3D-CRT for PVTT improved the response rate of PVTT and reduced the incidence of portal hypertension-related events.
引用
收藏
页码:492 / 502
页数:11
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