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)

Hepatoma accounts for less than 2% of all cancer death in this country, but it is responsible for 10-20% lethal malignancy in Asia and Africa. There are racial differences in its clinical manifestation, association with cirrhosis and/or hepatitis viral infection, pattern of spread, and prognosis. Mass screening program in China using alpha-fetal protein test has detected earlier cases, improved resectability and cure rate. About 10-15% of the patients in this country had surgical treatment. For patients with locally advanced and unresectable carcinoma, regional therapies such as infusion chemotherapy (IA hepatic or IV portal), ligation of hepatic artery, radiotherapy (external or internal), immunotherapy, either singularly or in various combinations have been tried. Despite the availability of Adriamycin and newer combinations of chemotherapeutic agents, patients with disseminated disease rarely respond. Other than earlier diagnosis, search for more effective drugs and multinodal approaches should be continued.
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PMID:Primary carcinoma of the liver: diagnosis, prognosis, and management. 618 96

Eighteen patients with malignant liver disease were treated with hepatic arterial infusion (HAI) of floxuridine (FUDR), Adriamycin (doxorubicin), and mitomycin C (FUDRAM). Twelve of the patients had primary hepatocellular carcinoma and six had metastatic liver carcinoma originating from an unknown primary site. One complete remission and seven partial remissions (greater than or equal to 50% reduction in tumor size) were observed among 12 hepatocellular cancer patients, while only one partial remission was achieved among six patients with unknown primary liver neoplasms. When arterial occlusion was added to HAI of FUDRAM, a prolongation of median survival to 14 months as opposed to six months in patients with an intact arterial tree was observed (P = 0.02). Arterial occlusion had its effect on survival particularly among patients who failed to respond to HAI of FUDRAM. Thus, among nonresponding patients, the addition of arterial occlusion resulted in a median survival of 10.5 months while median survival in those without arterial occlusion was six months (P = 0.08). With procedure-related morbidity being minimal, we conclude that arterially administered FUDRAM offers a notable palliation to patients with primary hepatocellular carcinoma. In patients with unknown primary liver neoplasms and those with hepatocellular cancer who fail HAI of FUDRAM, arterial occlusion can offer additional palliation.
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PMID:Hepatic arterial chemotherapy and occlusion for palliation of primary hepatocellular and unknown primary neoplasms in the liver. 618 57

The serum ferritin level was raised in 34 of 35 (97%) patients with hepatocellular carcinoma and in 20 of 23 (87%) with uncomplicated cirrhosis. Levels rose following therapeutic embolisation in 14 of 15 patients and continued to rise in 85% of all tumor patients who showed no clinical response to chemotherapy (intravenous Adriamycin) whereas in those who did respond the serum ferritin level fell. By contrast, there was a fall in serum alphafetoprotein immediately after embolisation but like serum ferritin, alphafetoprotein levels rose with disease progression and only fell in those achieving clinical remission. Serum ferritin has no role in the differential diagnosis of hepatocellular carcinoma but may be a useful marker in monitoring response to chemotherapy particularly in the alphafetoprotein-negative patient.
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PMID:Serum ferritin in hepatocellular carcinoma. A comparison with alphafetoprotein. 618 26

Eleven unresectable hepatoma patients and three metastatic tumor patients with colonic cancer underwent ligation and/or catheterization of the hepatic artery of the main tumor-bearing zone. Mitomycin C (liquid or microcapsulated) or Adriamycin were administered via the catheter intermittently or continuously with a portable pump device. In follow-up study the tumor size was frequently visualized by arteriography via the cannula. Some tumors became smaller with calcification. The levels of alpha-Fetoprotein of CEA in some cases dropped remarkably and stayed low for a fairly long period. There was no immediate postoperative death. Six of 11 unresectable hepatoma patients survived longer than 8 months with a maximum survival of 17.5 months. Two of three metastatic patients have survived more than 11 months at this writing. This method seems effective for prolongation of patient survival.
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PMID:Ligation and catheterization of the hepatic artery for palliative treatment of malignant hepatic tumors. 619 88

In a prospective clinical trial, 39 patients with advanced hepatocellular carcinoma were randomized to receive either Adriamycin (20 patients) or a combination of 5-fluorouracil, methotrexate, cyclophosphamide, and vincristine (19 patients). Five patients receiving Adriamycin and none receiving quadruple chemotherapy responded (P less than 0.05 in favor of Adriamycin). A further 25 patients were treated with Adriamycin, making a total of 45. The overall objective response rate was 24% (11 patients), with 3 complete remissions and 8 partial remissions. The median survival for Adriamycin-treated patients (13.0 weeks for the first 20 patients and 14.4 weeks for all patients) was longer than those treated by quadruple chemotherapy (6.5 weeks). The difference, however, was not significant by the Wilcoxan test as modified by Gehan. Patients with positive HbsAg had a significantly higher chance of having a response, while serum alpha-fetoprotein levels did not correlate with response.
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PMID:Chemotherapy for advanced hepatocellular carcinoma. Adriamycin versus quadruple chemotherapy. 619 58

The treatment of 205 patients with primary hepatocellular carcinoma in Singapore from 1975 to 1980 is reviewed. Adriamycin given at a dose of 40 mg/m(2) intravenously every 4 weeks for irresectible tumours achieved a response rate of 32% alone and has significantly prolonged the median survival time to 4 1/2 months (135 days) in these individuals. Despite this response only 1/34 (3%) patient showed complete remission and is alive at 2 1/2 years. Use of other combinations with Adriamycin e.g. 5 Fluorouracil and Vincristine produced a significant response in the first 16 weeks (p < 0.005) but not thereafter, when completed with the historical group. To improve the response and to consolidate this response, split doses of total hepatic irradiation (to a maximum of 3,150 rads) and alternate day administration of intravenous Adriamycin 10 mg (to a maximum of 90 mg) were given. 12/23 patients (50%) responded. This was followed by a four weekly Adriamycin, 5 F.U. and Vincristine. Median survival time was 5 1/2 months (165 days). Relapse occurred in all patients. Similarly in 5 patients who had resections, early recurrences occurred in 3/5 (60%) within 3 months, inspite of postoperative chemotherapy with Adriamycin, 5 F.U., Vincristine and Cyclophosphamide given every four weeks. In view of the high recurrence rate following effective treatment, further studies on the biological behaviour of these abnormal livers is required.
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PMID:Adriamycin in the treatment of resectible and irresectible primary hepatocellular carcinoma. 625 16

Twenty-one patients with unresectable hepatocellular carcinoma (hepatoma) were treated with adriamycin (15-45 mg/m2 q21 D) and methyl-CCNU (75-150 mg/m2 q 63 D) with dosage adjusted for hepatic dysfunction. Objective response frequency was 14% with all responses occurring in patients with normal pretreatment bilirubin levels. Median survival of all patients was 87 days. Initial bilirubin levels greater than 2 mg/dl predicted for decreased survival (median 30 days vs. 115 days, P less than 0.05). Only moderate hematologic toxicity was observed. Plasma profiles of Adriamycin and adriamycinol were determined during 11 courses of Adriamycin administration in seven of these patients. Despite moderately elevated transaminase levels (all cases) and bilirubin levels (three cases), plasma Adriamycin profiles in hepatoma patients were not elevated (terminal half-life of 30 hours) and were indistinguishable from that of non-hepatoma patients with normal liver functions. However, delayed appearance of peak levels and prolongation of terminal half-lives were routinely observed for adriamycinol, a major metabolite of Adriamycin. This resulted ina significant increase in the CXT (concentration X time) ratio of adriamycinol/Adriamycin in hepatoma patients compared with nonhepatoma patients (2.36 +/- 2.12 vs 0.76 +/- 0.31, (P less than 0.05). We conclude that the combination of relatively mild toxicity and normal Adriamycin disposition indicates unusual tolerance to Adriamycin therapy for patients with hepatoma and cirrhosis. As a result, severe dosage adjustments of Adriamycin may not be indicated for all such patients having only moderate hepatic dysfunction.
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PMID:Adriamycin and methyl-CCNU combination therapy in hepatocellular carcinoma: clinical and pharmacokinetic aspects. 626 77

Eight children presenting with unresectable primary hepatic malignancies were treated with chemotherapy in an attempt to decrease the size of the tumor. Adriamycin was used in all drug regimens, usually in combination with cyclophosphamide, vincristine, and 5-fluorouracil. Seven children exhibited a pronounced, clinical response with marked reduction in the size of the primary tumor as well as any pulmonary metastases present. Four children were able to have complete, uncomplicated surgical excision of residual disease, and three are alive and well off therapy. One patient with hepatocellular carcinoma had compete disappearance of all disease with chemotherapy alone. An approach utilizing preoperative chemotherapy for extensive hepatic malignancies may permit eventual resection of initially inoperable lesions, with long-term survival for these highly lethal malignancies.
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PMID:Preoperative chemotherapy for unresectable primary hepatic malignancies in children. 628 84

Following a pilot study of VP-16.213 (180 mg/m2 on 3 consecutive days at 2 weekly intervals) in the treatment of patients with hepatocellular carcinoma, the efficacy of the drug was compared with that of adriamycin in another 35 patients in a randomized crossover trial. Each drug gave a similar response rate (18 and 28%, respectively) but the duration of response was significantly longer in those receiving Adriamycin. Some patients who had not responded to treatment with Adriamycin had worthwhile remission with VP 16.
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PMID:Induction of remission in hepatocellular carcinoma. A comparison of VP 16 with adriamycin. 629 96

Twenty-two cases of non-operable hepatocellular carcinoma (HCC) were treated with three types of chemotherapy mainly with Adriamycin (ADM). In the group (A), one shot intraarterial infusion of 100 mg ADM into the hepatic artery (9 cases), group (B), one shot intraarterial infusion of 30 mg ADM (3 cases), and group (C), 20-60 mg of systemic administration of ADM (10 cases) were examined. The therapeutic effects and side effects were studied comparatively among these three groups. In terms of tumor regression, RR was 4 cases (44.4%), and MR was 4 (44.4%) in group (A), and PR was 1 (10%) in group (C). The average survival time was 8.3 months (5 cases are still alive) in group (A), 5.7 months in group (B), and 4.2 months in group (C), respectively As side effects, alopecia was found 100% in (A), 33% in (B); leukocytopenia was found 100% in (A), 33% in (B); but no serious complication due to leukocytopenia was observed in any of them. One shot of 100 mg of ADM intraarterial infusion therapy seemed to be superior in therapeutic effects against HCC over other therapies.
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PMID:[Chemotherapy of hepatocellular carcinoma--with special reference to one-shot intra-arterial infusion of a high dose of adriamycin]. 630 82


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