Prospective Evaluation of Transcatheter Arterial Chemoembolization (TACE) with Multiple Anti-Cancer Drugs (Epirubicin, Cisplatin, Mitomycin C, 5-Fluorouracil) Compared with TACE with Epirubicin for Treatment of Hepatocellular Carcinoma
- 864 Downloads
To compare the efficacy of transcatheter arterial chemoembolization (TACE) using multiple anticancer drugs (epirubicin, cisplatin, mitomycin C, and 5-furuorouracil: Multi group) with TACE using epirubicin (EP group) for hepatocellular carcinoma (HCC).
Materials and Methods
The study design was a single-center, prospective, randomized controlled trial. Patients with unrespectable HCC confined to the liver, unsuitable for radiofrequency ablation, were assigned to the Multi group or the EP group. We assessed radiographic response as the primary endpoint; secondary endpoints were progression-free survival (PFS), safety, and hepatic branch artery abnormality (Grade I, no damage or mild vessel wall irregularity; Grade II, overt stenosis; Grade III, occlusion; Grades II and III indicated significant hepatic artery damage). A total of 51 patients were enrolled: 24 in the Multi group vs. 27 in the EP group.
No significant difference in HCC patient background was found between the groups. Radiographic response, PFS, and 1- and 2-year overall survival of the Multi vs. EP group were 54% vs. 48%, 6.1 months vs. 8.7 months, and 95% and 65% vs. 85% and 76%, respectively, with no significant difference. Significantly greater Grade 3 transaminase elevation was found in the Multi group (p = 0.023). Hepatic artery abnormality was observed in 34% of the Multi group and in 17.1% of the EP group (p = 0.019).
TACE with multiple anti-cancer drugs was tolerable but appeared not to contribute to an increase in radiographic response or PFS, and caused significantly more hepatic arterial abnormalities compared with TACE with epirubicin alone.
KeywordsHepatocellular carcinoma Transcatheter arterial embolization Anticancer drugs Epirubicin Cisplatin
Conflict of interest
We have no financial disclosures to declare.
- 5.Chang JM, Tzeng WS, Pan HB et al (1994) Transcatheter arterial embolization with or without cisplatin treatment of hepatocellular carcinoma. A randomized controlled study. Cancer 74:2449–2453Google Scholar
- 6.Kawai S, Okamura J, Ogawa M et al (1992) prospective and randomized clinical trial for the treatment of hepatocellular carcinoma: A comparison of lipiodol-transcatheter arterial embolization with and without Adriamycin (first cooperative study). The Cooperative Study Group for Liver Cancer Treatment of Japan. Cancer Chemother Pharmacol 31(Suppl):S1–S6PubMedCrossRefGoogle Scholar
- 18.Kamada K, Nakanishi T, Kitamoto M et al (2001) Long-term prognosis of patients undergoing transcatheter arterial chemoembolization for unresectable hepatocellular carcinoma: comparison of cisplatin Lipiodol suspension and doxorubicin hydrochloride emulsion. J Vasc Interv Radiol 12:847–854PubMedCrossRefGoogle Scholar
- 20.Kawai S, Tani M, Okamura J et al (1997) Prospective and randomized trial of lipiodol-transcatheter arterial chemoembolization for treatment of hepatocellular carcinoma: a comparison of epirubicin and doxorubicin (second cooperative study). The Cooperative Study Group for Liver Cancer Treatment of Japan. Semin Oncol 24(S6):38-45Google Scholar
- 22.Masuda M (2002) Evaluation of basic and clinical study on effect of anticancer drugs of lipiodol in chemoembolization on liver tissue. J Wakayama Med Soc 53:185–192Google Scholar