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)

Recently, we developed an intrahepatic artery catheter and a device attached with an implantable double lumen reservoir. In this paper, we present clinical experience with this device in 15 cases of hepatocellular carcinoma and the results of an experimental study using canine regarding the significance of arterial infusion therapy with occlusion of hepatic arterial flow. Adriamycin and CDDP were used as anticancer agents, and in 3 out of 15 cases IL-2 and LAK cell were used as chemoimmunotherapy. Twenty-one infusions were possible without any severe side effects. This treatment was also safely done even in the out-patient clinic. In one case extravasation of drug and another case of fever caused by catheter were seen, which was easily diminished by conservative treatment. Ten cases were estimated for antitumor effects and 5 showed partial remission. In experimental study, augmentation of the intrahepatic tissue level of adriamycin was found with occlusion of arterial flow. Intra-arterial infusion therapy using this device promises to be a most useful routine method for cancer control in the outpatient clinic.
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PMID:[Intra-arterial infusion chemotherapy under flow occlusion using a double lumen reservoir]. 278 9

Hepatocellular carcinoma is often an aggressive tumour and, if unresectable, carries a poor prognosis, especially in the presence of jaundice. We report on a jaundiced patient with an unresectable fibrolamellar hepatocellular carcinoma treated with intra-arterial lipiodolised doxorubicin (Adriamycin). The initial response of the patient has been encouraging. This form of therapy deserves further evaluation in patients with unresectable hepatocellular carcinoma.
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PMID:Unresectable fibrolamellar hepatocellular carcinoma treated with intra-arterial lipiodolised doxorubicin. A case report. 282 64

The histories of 73 patients with hepatocellular carcinoma (HCC) confined to the liver who were seen at M. D. Anderson Hospital between January 1976 and December 1983 were reviewed. In 18 patients the tumor was resected either at the outset or after the patients' response to chemotherapy; nonsurgical treatments consisted of hepatic arterial infusion (HAI) in 10 patients and intravenous (IV) therapy in four patients. Patients who had resection were younger, and their liver functions and performance status were better than the IV and HAI groups. Their median survival was 46 months. Of the patients who had nonresectable tumors, 28 received chemotherapy by HAI and 27 received IV therapy. Of the 28 patients in the HAI treatment group, 25 received uniform infusion of floxuridine (FUDR, Roche, Australia), doxorubicin (Adriamycin), and mitomycin C (FUDRAM). Of the 27 patients in the IV treatment group, 15 received 5-fluorouracil (5-FU) and doxorubicin-containing regimens; in 11 patients 5-FU was combined with other agents. The HAI and IV treatment groups were similar in age and ethnicity, performance status, serum alpha-fetoprotein levels, liver function, presence of hepatitis B antigen, and presence or absence of cirrhosis. The median survival was 9 months for HAI-treated patients and 5 months for the IV-treated group. The statistical differences were resection versus HAI, P less than 0.01; resection versus IV, P less than 0.01; HAI versus IV, P less than 0.01. Thirteen of 18 patients who had resections, six of 28 patients treated with HAI, and two of 27 IV-treated patients survived 2 years or more. It is concluded that for patients with hepatocellular carcinoma confined to the liver, the option of tumor resection either at the beginning of treatment or after chemotherapy offers the best chances for long-term survival. The overall prognosis is poor for patients with nonresectable hepatocellular carcinoma, but arterial infusion chemotherapy may double the median survival as compared to IV chemotherapy.
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PMID:Hepatocellular carcinoma. A retrospective analysis of treatments to manage disease confined to the liver. 283 42

An intra-arterial injection of an Adriamycin-Lipiodol emulsion and a Mitomycin C microcapsule has been given to two patients of hepatocellular carcinoma (HCC) complicated with a tumor thrombosis of the portal trunk. One patient showed a partial response, while the other evidenced no change, alpha-Fetoprotein decreasing from 4510 to 419 ng/ml in the partial response case, and from 328 to 283 ng/ml in the no change case. In each instance the hepatic injury treated by this combination therapy was mild and reversible. Bone marrow suppression by this therapy was not demonstrated. Thus, this therapy is thought to be applicable to cases of hepatocellular carcinoma complicated with a tumor thrombosis of the portal trunk who should not be indicated for transcatheter arterial embolization.
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PMID:[Effect of combination therapy with an adriamycin-lipiodol emulsion and a mitomycin C microcapsule in hepatocellular carcinoma complicated by portal thrombosis]. 283 37

From 1976 to 1983, 28 patients (24 male and four female) with unresectable hepatocellular carcinoma (HCC) were treated by intraarterial chemotherapy at the Istituto Nazionale Tumori of Milan, Milan, Italy. Tumors were retrospectively classified by a previously proposed staging system. Two patients were classified as Stage I and 26 as Stage II. Liver cirrhosis was present only in the males (in 50% of them). Nineteen patients were treated with doxorubicin (Adriamycin [Adria Laboratories, Columbus, OH]) and nine with 5-fluorouracil. Systemic toxicity was mild, but the treatment induced hepatic toxicity (ascites, clinical jaundice, or biochemical impairment) in 18% of noncirrhotic and 66% of cirrhotic patients. Clinical reduction of hepatomegaly was observed in 50% of noncirrhotic versus 16% of cirrhotic patients. Doxorubicin was effective in 66% of noncirrhotic patients and 20% of cirrhotic patients, with an overall response rate of 42%. 5-fluorouracil was effective only in patients without cirrhosis, with an overall response rate of 22%. Overall median actuarial survival was 3.5 months, with a significant difference between noncirrhotic and cirrhotic patients (6 versus 2 months, respectively). Overall median survival of patients who responded to the treatment was 13 versus 2 months for nonresponders (P less than 0.001). Liver cirrhosis was the most important prognostic factor in terms of liver toxicity, response rate, and survival. This study emphasized the negative impact of the treatment on cirrhotic patients. Also, the real value of intraarterial administration of doxorubicin was investigated.
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PMID:Intrahepatic chemotherapy for unresectable hepatocellular carcinoma. 283 36

Twenty-eight cases with non-resectable hepatocellular carcinoma were examined. Chemoembolization using degradable starch microspheres (DSM) was performed in 19 cases. DSM, 40-45 micron in diameter, which are degraded by serum amylase, temporarily obstruct arterial blood flow at capillary bed. Adriamycin mixed with DSM was injected into patients through the proper hepatic artery. Hyperthermia (8 MHz radiofrequency) combined with chemoembolization was performed in 9 cases. In all cases treated by hyperthermia combined with chemoembolization, the intratumoral temperature was measured by a thermocouple thermometer during heating alone and heating after injection of DSM. The therapeutic effect was evaluated by the change in tumor size measured by angiography or computed tomography. The efficacy of hyperthermia combined with chemoembolization was compared with that of chemoembolization alone. Intratumoral temperature was 1.0 degree C higher by heating after injection of DSM than by heating alone. Partial response (tumor regression of over 50%) was observed in 8 of 19 cases (42%) with chemoembolization alone. Partial response was observed in 6 of 9 cases (67%) with hyperthermia combined with chemoembolization. One-year survival rate was 58% in chemoembolization alone, against 83% in hyperthermia combined with chemoembolization. Our results suggest that hyperthermia combined with chemoembolization using DSM is effective in the treatment of hepatocellular carcinoma.
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PMID:[Effects of hyperthermia combined with chemoembolization using degradable starch microspheres in the treatment of hepatocellular carcinoma]. 283 95

To assess the efficacy and safety of Adriamycin (Adria Laboratories, Columbus, OH) in inoperable hepatocellular carcinoma (HCC), 60 patients were randomized to receive Adriamycin 60 to 75 mg/m2 at 3-week intervals and 46 patients to receive no antitumor therapy. The median survival rate of the Adriamycin group was 10.6 weeks; that of the group receiving no antitumor therapy was 7.5 weeks (P = 0.036). Adriamycin induced tumor regression of 25% to 50% in 5% of patients and of over 50% in only 3.3% of patients. It caused fatal complications (septicemia and cardiotoxicity) in 25% of patients. The severity of neutropenia leading to septicemia for a particular dose was unpredictable. Four of eight patients who developed cardiotoxicity received less than 500 mg/m2 of Adriamycin. We conclude that Adriamycin is not an ideal drug for the treatment of inoperable HCC.
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PMID:Doxorubicin versus no antitumor therapy in inoperable hepatocellular carcinoma. A prospective randomized trial. 283 80

In an attempt to develop a selective long-acting chemotherapy for hepatocellular carcinoma, lipiodol emulsion (Lp-Em) was prepared using non-ionic surfactant, poloxamer-188. A pharmacokinetic study of Adriamycin (ADM) was carried out according to the paddle method, and concentrations of ADM were measured with spectrophotometer at wave length 475 nm. The half time of ADM levels in Lp-Em were longer than that in lipiodol urografin suspension. Histological findings of chemical hepatocarcinogenic rat after their administration showed Lp-Em, lipiodol and ADM accumulations in hepatocellular carcinoma lesion. Transcatheter arterial embolization with Lp-Em containing 40 mg of ADM was performed in 6 patients with unresectable hepatocellular carcinoma. CT scan after treatments revealed high-density areas in the hepatocellular carcinoma lesion as the deposition of lipiodol. Serum concentrations of ADM were significantly lower in a patient treated with Lp-Em than with lipiodol urografin suspension. In conclusion, Lp-Em is thought to be useful for the treatment of hepatocellular carcinoma.
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PMID:[Pharmacological and clinical studies on lipiodol emulsion for hepatocellular carcinoma]. 284 21

Preoperative chemoembolization was performed in 10 patients with hepatocellular carcinoma. The therapeutic regimen included Adriamycin (ADM) solved in nonionic contrast media, Iopamiron and Lipiodol (LP). Two to four ml of the solution, containing 20-40 mg of ADM, was mixed with 5-10 ml of LP by "pumping" method. This emulsion was infused superselectively into the hepatic artery by the balloon-occluded method. The regimen contained no permanent embolic material (e.g., Gelfoam or Ivaron). Dense deposition of LP in the tumor was seen on the CT scan 3-4 weeks after TAI. Surgical specimens, resected 3-12 weeks after TAI, revealed total necrosis of the tumor in 4 cases, subtotal necrosis (more than 80% on the cut surface) in 3 cases, and partial necrosis (less than 80%) in 3 cases. Tumor invasion in the fibrous capsules was necrosed in 4/7 of the cases. Tumor thrombi in the portal vein were also necrosed in 2/4. Our new method is more effective than the previous ones of LP and ADM without Iopamiron, and is equally effective as the regimen using LP, anticancer drugs, and permanent embolic materials.
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PMID:[Preoperative chemoembolization of iopamiron-solved adriamycin and lipiodol on hepatocellular carcinoma--clinicopathological study of ten surgical cases]. 284 22

From January 1984 to December 1987, 63 unresectable liver cancers (22 hepatocellular carcinoma and 41 metastatic liver cancer) were treated with multidisciplinary therapy: partial resection of liver, hepatic arterial infusion, coagulation therapy using microwave tissue coagulator and intratumoral injection of the liver. The median survival period was 5-7 months, and the clinical response rate was 21.6% in these therapies, but there was no statistically significant difference between the treatments. Recently, we usually use degradable starch microspheres (DSM) with anticancer agents in hepatic arterial infusion. Adriamycin + DSM was administered for hepatocellular carcinoma, and Mitomycin C + DSM was used for metastatic liver cancer. The regimens were used for 12 cases, 6 of hepatocellular carcinoma and 6 of metastatic liver cancer, with a response rate of 50%, respectively. We also undertook chemosensitivity tests for liver cancer. The coincidence of clinical response with results of chemosensitivity tests was above 50%. In future, we shall use the most effective anticancer agents for individual tumors with DSM in arterial infusion.
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PMID:[Multidisciplinary treatment of unresectable liver cancer]. 284 27


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