Hepatocellular carcinoma (HCC) is one of the most common cancer-related causes of death worldwide and there is a clear need for further treatment options. In this study, we assessed the efficacy of a combination of lentinan (a fungal extract), transcatheter arterial chemoembolisation (TACE) and radiofrequency ablation (RFA) in HCC patients.
Seventy-eight patients with HCC confirmed by pathology and iconographical checks were used in this study. A total of 136 tumours with a mean diameter of 6.5 cm were detected (standard deviation [SD]±0.7). Subjects were divided into four groups, receiving either TACE only, RFA only, RFA and TACE, or the combination group — receiving lentinan, RFA and TACE.
The tumour necrosis was significantly higher in the combination group (88.6%), compared to the TACE group (37.5%), the RFA group (47.8%) and the TACE/RFA group (60.3%; P<0.05). The tumour recurrence rate was significantly lower in the combination group (17.8%), compared to the TACE group (45.8%), the RFA group (34.7%) and the TACE/RFA group (29.0%; P<0.05). Finally, mean survival duration was significantly higher in the combination group (28.2 months; P<0.05).
Combination therapy involving lentinan, RFA and TACE was beneficial in terms of increasing mean survival duration, tumour necrosis and reducing the recurrence rate. Lentinan may therefore be of benefit to HCC patients.
Höpfner M, Huether A, Sutter A, Baradari V, Schuppan D, Scherübl H. Blockade of IGF-1 receptor tyrosine kinase has antineoplastic effects in hepatocellular carcinoma cells. Biochem Pharmacol. 2006;71:1435–1448.
Cormier JN, Thomas KT, Chari RS, Pinson CW. Management of hepatocellular carcinoma. J Gastrointest Surg. 2006;10:761–780.
Ryder SD. Guidelines for the diagnosis and treatment of hepatocellular carcinoma (HCC) in adults. Gut. 2003;52:1–8.
McEntee GP, Nagorney DM, Kvols LK, Moertel CG, Grant CS. Cytoreductive hepatic surgery for neuroendocrine tumors. Surgery. 1990;108:1091–1096.
Lee CM, Lu SN, Changchien CS, et al. Age, gender, and local geographic variations of viral etiology of hepatocellular carcinoma in a hyperendemic area for hepatitis B virus infection. Cancer. 1999;86:1143–1150.
Moertel CG, Johnson CM, McKusick MA, et al. The management of patients with advanced carcinoid tumors and islet cell carcinomas. Ann Intern Med. 1994;120:302–309.
Baere T, Dufaux J, Roche A, et al. Circulatory alterations induced by intraarterial injection of iodized oil and emulsions of iodized oil and doxorubicin: experimental study. Radiology. 1995;194:165–170.
De Mitri MS, Puossin K, Baccarini P, et al. HCV-associated liver cancer without cirrhosis. Lancet. 1995;345:413–415.
Liapi E, Geschwind JFH. Transcatheter arterial chemoembolisation (TACE) for HCC’ classic concepts and future evolution. Eur Oncological Dis. 2006;1:47–52.
Tsukuma H, Hiyami T, Tanaka S, et al. Risk factors for hepatocellular carcinoma among patients with chronic liver disease. N Engl J Med. 1993;328:1797–1801.
Frazer C. Imaging of hepatocellular carcinoma. J Gastroenterol Hepatol. 1999;14:750–756.
Sugimori K, Nozawa A, Morimoto M, et al. Extension of radiofrequency ablation of the liver by transcatheter arterial embolization with iodized oil and gelatin sponge: results in a pig model. J Vasc Interv Radiol. 2005;16:849–856.
Dominguez S, Denys A, Madeira I, et al. Hepatic arterial chemoembolization with streptozotocin in patients with metastatic digestive endocrine tumors. Eur J Gastroenterol Hepatol. 2000;12:151–157.
Casadei R, Tomassetti P, Rossi C, la Donna M, Migliori M, Marrano D. Treatment of metastatic glucagonoma to the liver: case report and literature review. Ital J Gastroenterol Hepatol. 1999;31:308–312.
Bizollon T, Rode A, Bancel B, et al. Diagnostic value and tolerance of lipiodolcomputed tomography for the detection of small hepatocellular carcinoma: correlation with pathologic examination of explanted livers. J Hepatol. 1998;28:491–496.
Wu P, Zhang F, Zhao M, et al. Combination of transcatheter arterial chemoembolization and CT-guided radiofrequency ablation in treating advanced hepatocellular carcinoma. Chin J Radiology (Chin). 2003;37:901–904.
Zhang L, Cui Z, Zhao Q, et al. RFA combined with TACE and ethanol injection for unresectable hepatic carcinoma. Chin J General Surg (Chin). 2002;40:826–829.
Lindequist U, Niedermeyer TH, Jülich WD. The pharmacological potential of mushrooms. eCAM. 2005;2:285–299.
Wasser SP, Weis AL. Medicinal properties of substances occurring in higher basidiomycetes mushrooms: current perspectives (review). Int J Med Mushrooms. 1999;1:31–62.
About this article
Cite this article
Yang, P., Liang, M., Zhang, Y. et al. Clinical application of a combination therapy of lentinan, multi-electrode RFA and TACE in HCC. Adv Therapy 25, 787–794 (2008). https://doi.org/10.1007/s12325-008-0079-x