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

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

The aim of this study was to elucidate the efficacy of intra-arterial 5-fluorouracil (5-FU) and interferon (IFN) α combined with three-dimensional conformal radiotherapy (3D-CRT) for portal vein tumor thrombosis (PVTT).

Methods

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.

Result

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.

Conclusion

5-FU/IFN combination with 3D-CRT for PVTT improved the response rate of PVTT and reduced the incidence of portal hypertension-related events.

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Authors and Affiliations

  1. Department of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Yoshio Katamura, Hiroshi Aikata, Shintaro Takaki, Takahiro Azakami, Tomokazu Kawaoka, Koji Waki, Akira Hiramatsu, Yoshiiku Kawakami, Shoichi Takahashi & Kazuaki Chayama

  2. Division of Radiation Oncology, Hiroshima University Hospital, Hiroshima, Japan

    Masahiro Kenjo

  3. Department of Radiology, Hiroshima University, Hiroshima, Japan

    Naoyuki Toyota & Katsuhide Ito

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  1. Yoshio Katamura
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  2. Hiroshi Aikata
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  3. Shintaro Takaki
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Correspondence to Hiroshi Aikata.

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Katamura, Y., Aikata, H., Takaki, S. et al. Intra-arterial 5-fluorouracil/interferon combination therapy for advanced hepatocellular carcinoma with or without three-dimensional conformal radiotherapy for portal vein tumor thrombosis. J Gastroenterol 44, 492–502 (2009). https://doi.org/10.1007/s00535-009-0033-y

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