Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019204 (hepatocellular carcinoma)
 71,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Transcatheter arterial embolization (TAE) has now been widely accepted in the treatment of hepatocellular carcinoma (HCC). Forty-five patients with tissue proven HCC received TAE and were followed up for more than 6 months; 28 of them were followed for more than one year and 13 for 2 years. The embolic materials used were Lipiodol 0.1-0.2 ml/cm2 (tumor area of its maximal diameter), which was prepared by pumping with contrast agent at a ratio of 1:2 and mixed with anticancer drugs (Mitomycin C: 8-10 mg or Adriamycin 40-50 mg), gelform particles 1-2 mm in size were subsequently embolized. The postembolization syndrome: abdominal pain, fever, nausea and vomiting usually subsided within 1-3 weeks. The overall cumulative half-year, 1-year and 2-year survival rates were 77.8%, 57.1% and 46.2%, respectively. Cases with regular follow-up and those with massive type without satellites, esp. when tumor size less than 5 cm, had better survival rates. In contrast, portal vein thrombosis and big tumors (especially with satellites) indicated poor prognosis. In addition, actively treated coexisting peptic ulcer and/or esophageal varices in HCC patients also improved TAE results.
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PMID:The outcome of hepatocellular carcinoma treated with transcatheter arterial chemoembolization. 217 16

A total of 20 children with recurrent or unresponsive tumours (10 Wilms' tumours, 3 rhabdomyosarcomas, 4 Ewing's sarcomas, 1 osteosarcoma, 1 hepatoblastoma, 1 hepatoma) were given ifosfamide as a 24-h infusion (5 g/m2), with mesna as a uroprotector. The number of courses ranged from 1 to 13 (median, 3), and the interval between them was 2-3 weeks. In all, 16 of these patients had previously received cyclophosphamide. Complete clinical responses (CRs) were seen in 3 cases (2 Wilms' tumours and 1 Ewing's sarcoma) and lasted 5, 7, and 9 months. Partial responses (PRs) were seen in 3 instances; mixed response or stable disease, in 4; and progressive disease, in 10. Treatment was well tolerated in most patients, with no cystitis or severe myelosuppression, but two children developed transient neurological symptoms and one became hypertensive. Nausea and vomiting were controlled by high-dose dexamethasone in most children.
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PMID:A phase II study of ifosfamide in paediatric solid tumours. 275 66

Twenty patients with focal malignant obstruction of the major bile ducts (6 cholangiocarcinoma, 8 colorectal, 3 hepatoma, 2 unknown primary, and 1 gastric cancer) were treated on a protocol examining the toxicity and efficacy in relieving jaundice of external beam radiation therapy (4500 cGy in 300 cGy fractions) combined with continuous hepatic arterial (15 patients) or peripheral venous (5 patients) fluorouracil infusion. Toxicity of this regimen consisted of anorexia with mild nausea and vomiting in 55% of patients and gastric ulceration (responsive to medical management) in 15% of patients. One patient exhibited transient grade 2 hepatic toxicity and one had asymptomatic grade 4 leukopenia. Of 14 patients treated without prior biliary drainage, 8 exhibited a decrease in bilirubin levels from a mean of 14.5 mg/dl to 1.5 mg/dl. Four of six patients with biliary drainage catheters at the start of treatment were able to have them removed without reobstruction. For the 8 responding patients among those who did not have cholangiocarcinomas, the median response duration was 5 months with a median survival from treatment of 6.5 months. For the 4 responding patients with cholangiocarcinoma, the median response duration was 16 months with a median survival from treatment of 20 months. All responders did not have a return of jaundice due to reobstruction of the major ducts (until death or to the present). All responders who have died did so due to tumor progression outside of the treated field except for one who died of unrelated causes. The mean number of proven or presumed episodes of cholangitis per patient was virtually identical in those without (1.8) and those with stents/tubes (1.4, p = 0.561). This regionally focused combined modality cytotoxic therapy was able to relieve obstruction in the majority of patients without excess morbidity (including a lack of any detectable increase in sepsis). Thus, it appears feasible to consider randomized studies of this cytotoxic approach versus standard mechanical drainage procedures to define the relative risks and benefits of each.
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PMID:Combination chemo-radiation therapy for jaundice due to focal malignant obstruction of the major bile ducts. 277 30

Twenty-one cases of unresectable hepatocellular carcinoma (HCC), including 15 cases receiving intravenous infusion of CDDP in addition to transcatheter arterial embolization (TAE), and 6 cases receiving intraarterial infusion of CDDP in combination with sodium thiosulfate rescue (STS rescue) were studied. In the 15 cases given intravenous infusion therapy with TAE, favorable effects were observed in 33.3% of patients, and the 50% survival period was 22.5 months. In the 6 cases given intraarterial infusion, favorable effects were obtained in 66.6% of patients, but the 50% survival period was 2 months. The side effects observed most frequently were nausea and vomiting. All the other side effects observed were not so severe. These results suggest that intravenous CDDP infusion in addition to TAE is favorable, producing a life-prolongation effect.
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PMID:[Clinical study of the effect of cisplatin therapy in unresectable hepatocellular carcinoma]. 282 86

An open phase II study of high-dose 4'epidoxorubicin (90 mg/m2) was conducted in 33 patients with inoperable hepatocellular carcinoma. Three out of the 33 (9%) patients showed tumour response. The treatment was relatively well tolerated with a moderate degree of haematological toxicity and alopecia, and a mild degree of nausea and vomiting. The overall median survival was 72 days with a prolongation in the patients who showed some response.
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PMID:The efficacy of high-dose 4'epidoxorubicin in hepatocellular carcinoma. 284 22

Metastasis of hepatoma to the central nervous system is rare, although hepatoma is a relatively common malignant tumor in Japan. Much rarer is metastatic hepatoma presenting as intracranial hemorrhage and there have been only 4 cases reported in the past. Here, we report two such rare cases with a literature review. Case 1 was a 26 years-old female with a history of 60% hepatic resection in the diagnosis of hepatocellular carcinoma. Later, she developed bilateral lung metastasis. She was admitted with complaints of headache, nausea and vomiting. Neurological findings were clear consciousness, right homonymous hemianopsia and bilateral papilledema. CT showed high-density mass in the left occipital lobe. Evacuation of hematoma and removal of tumor were performed. Pathological diagnosis was hepatocellular carcinoma of clear cell type. Later, two other hemorrhage occurred from different metastatic lesions in the left occipital lobe and the right occipital lobe, and the patient underwent two more surgeries. The patient died of lung metastasis, three months from neurological onset. Case 2 was a 42 years-old male who developed an intracranial tumor adjacent to the right temporal bone without a history of hepatoma. The tumor was removed, which turned out to be hepatocellular carcinoma pathologically. Three months later, on admission, the patient showed sudden neurological deterioration into deep coma. CT showed an irregular high-density mass in the right temporal lobe and evacuation of hematoma coupled with tumor removal was performed. Pathology was of trabecular type. Later, intracranial recurrence and bony metastasis to C5, L3 and the left iliac bone appeared.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Metastatic hepatoma presenting as intracranial hemorrhage: report of two cases]. 284 59

Ten consecutive adults with localized nonresectable hepatocellular carcinomas were selected as a nonrandom sample for an investigation into the effectiveness of cisplatin (DDP) as a single agent when administered regionally via the hepatic artery from 1981 to 1984. The dose of DDP was 50 mg/m2 (normally, 80 mg). Complete remission (CR) was observed in one patient, partial remission (PR) in three patients, and in five patients, there were no significant changes in tumor size; the disease progressed in one patient. The mean period of survival of the group was 19.7 months. All patients suffered from severe nausea and vomiting, ordinarily until the afternoon of the day after treatment. One patient died of uremia, which related to the cytostate. The authors consider cisplatin useful in the intra-arterial treatment of hepatocellular carcinoma with favorable prognostic factors in patients for whom surgical treatment is not suitable.
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PMID:Regional intra-arterial infusion of cisplatin in primary hepatocellular carcinoma. A phase II study. 302 14

Twenty-three patients (16 male, seven female) with hepatocellular carcinoma (HCC) were treated by hepatic arterial infusion (HAI) of mitoxantrone every 4 weeks. At each treatment, a catheter was inserted percutaneously into the main hepatic artery via the femoral artery under image intensification. Treatment consisted of a 24-hour continuous HAI of mitoxantrone, 6 mg/m2/d X 3 (eight patients) or 10 mg/m2/d X 3 (14 patients) without heparin. Eight patients had only one infusion, nine patients four infusions, five patients three infusions, two patients two infusions, and one patient five infusions. A partial response was seen in six patients, with a median duration of 20 weeks (range, 18 to 38 weeks). Five patients achieved stable disease, with a median duration of 20 weeks (range, 11 to 42 weeks). The median survival of the overall group was 22 weeks. Survivals of responding, stable, and nonresponding patients were 32 weeks, 24 weeks, and 9 weeks, respectively. Complications of catheter placement included asymptomatic dissection of the hepatic artery (one patient), and asymptomatic thrombosis of the hepatic artery (five patients). Three patients experienced mild nausea and vomiting, and six patients had mild to moderate alopecia. Granulocytopenia was frequent at both dose schedules. The granulocyte nadir was greater than 1,000/microL in 34% of evaluable courses, 500 to 1,000/microL in 32%, and less than 500/microL in 34% of courses. Two patients developed neutropenia-associated fever. A platelet nadir below 100,000/microL was seen after only 10% of courses, and only two patients had platelets below 50,000/microL. Seven patients received doxorubicin after progression on mitoxantrone. Four received systemic doxorubicin, 50 mg/m2, and three HAI of doxorubicin, 25 mg/m2, for three days. Two patients achieved partial response (18 weeks and 32 weeks) to HAI doxorubicin. Mitoxantrone has activity in HCC and is well tolerated when administered by HAI. It is not entirely cross-resistant with doxorubicin.
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PMID:Hepatic arterial infusion of mitoxantrone in the treatment of primary hepatocellular carcinoma. 303 Dec 27

Thirteen patients with cancer of the gut, six with hepatocellular carcinoma and three with cancer of the bile duct have been treated with tegafur. All the patients were in an advanced stage of the disease with metastases to lymph-nodes or elsewhere. Each patient was given tegafur (oral daily dose of 600-1200 mg for 15-30 days with a dose-free interval of 25 days). Tegafur with other antiblastic drugs (such as cyclophosphamide, methotrexate, vincristine, doxorubicin, mitomycin) was given to ten patients. The results observed after the first treatment were as follows: partial remission in 14 patients (64%), no change in 4 (18%) and progression of the disease in 4 (18%). Only 10 patients among the 22 who were first treated, underwent one to three subsequent cycles of therapy obtaining with resultant partial remission in four cases, no change in two and progression of the disease in four patients. Side-effects (nausea and vomiting) during the treatment were recorded only in 14% of the patients. No significant impairment of blood functional tests has been documented. A comparison of the results obtained with tegafur and intravenous 5-fluorouracil has been made: the therapeutic effects of these two drugs are similar, but side-effects seem to be less during tegafur treatment.
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PMID:Tegafur chemotherapy for the treatment of gut and liver cancer. 309 13

Oxalato-platinum in a new platinum derivative which was found to be active in experimental tumors and devoid of nephrotoxicity. A phase I study was conducted in cancer patients according to a new design following the recommendations of our Institution's ethical committee to avoid the major drawback of classical phase I studies in which many patients receive the experimental drug at doses far under the potentially active dose extrapolated from experimental studies. The potentially active dose of l-OHP was determined from the Maximally Efficient Dose Range (MEDR) to be between 45 mg/m2 (subcurative dose) and 67 mg/m2 (subtoxic dose). The patients in this study received with increasing intervals 1/100, 1/10, 1/5, 1/3, 1/2, 2/3, 3/4, 1, of the low dose of the MEDR, this dose being reached after 90 to 120 days on study. 23 evaluable patients have entered the trial of which 19 reached the low dose of MEDR (45 mg/m2). Gastro-intestinal toxicity, nausea and vomiting, similar to those with CDDP occurred in all patients at or above the dose of 30 mg/m2. Renal toxicity was monitored with creatinine level and did not occur in any patient at any dose nor did significant hematologic toxicity occur. Thus nausea and vomiting appear to be the limiting toxicity of the drug. Responses were observed in this phase I study in lung cancer (1), breast cancer (1), melanoma (1) and perhaps hepatoma (major decrease in alpha FP levels) (1). The proposed starting dose for phase II studies is 45 mg/m2 but we plan to continue dose escalation during the phase II according to the design of Jones and Holland. This new study design allows each patient entering a phase I study to be treated with a potentially active dose of the drug studied.
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PMID:A phase I trial of trans-1-diaminocyclohexane oxalato-platinum (l-OHP). 358 May 5


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