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

Seventy-five surgically treated patients with hepatocellular carcinoma (HCC) of Stage III or IV-A were divided into two groups: group I, control without postoperative adjuvant infusion (PAI); group II, patients treated with PAI. In the PAI group, 29 patients (mean diameter of tumors = 71 mm) prophylactically underwent PAI after hepatic resection. Chemotherapeutic agents, (5-FU, ADM, MMC, CDDP and Lipiodol) were administered 4 times a year via the hepatic artery through Infuse A port. The remaining 46 patients (mean diameter of tumors = 70 mm) served as the historical control without PAI. The 4-year cumulative survival rate was higher in the PAI group (45.6%) than in the control (25.4%, p = 0.0424). The 4-year disease-free survival rate was also improved in the PAI group (37.0%) compared with that in the control (14.4%, p = 0.0096). Intrahepatic multiple recurrence was recognized in 8 out of 29 patients in the PAI group (28%) and in 24 out of 46 in the control (53%, p = 0.036) within 1 year after surgery. Extrahepatic recurrence without diseases in the remnant liver tended to occur with higher frequency in the PAI group than in the control. Based on our data, we suggest that PAI is effective in alleviating intrahepatic multiple recurrence within 1 year after hepatic resection for advanced HCC and that systemic chemotherapy may be necessary for preventing extrahepatic recurrence.
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PMID:[Postoperative adjuvant arterial infusion chemotherapy in patients with advanced hepatocellular carcinoma]. 757 38

In this study, we evaluated the effectiveness of the arterial infusion chemotherapy through an implantable port for the treatment of advanced hepatocellular carcinoma. The chemotherapy comprised weekly or biweekly administrations of epi-ADM combined with 5-FU and MMC. The patients were divided into 4 groups as follows: 1) 37 patients treated mainly by repeat transcatheter arterial embolization (TAE) (TAE group); 2) 16 patients treated by arterial infusion chemotherapy through implantable port after TAE (TAE-RV group); 3) 9 patients with no indication for TAE treated by one-shot arterial infusion chemotherapy (one-shot group); and 4) 13 patients with no indication for TAE treated by arterial infusion chemotherapy through an implantable port (RV group). The median survival after the complete courses of TAE was 23 weeks in the TAE group, and 59 weeks in the TAE-RV group. There was a statistically significant difference in median survival time between the TAE group and the TAE-RV group (p < 0.01). On the other hand, the median survival time after the initial administration of an anticancer agent was 9 weeks in the one-shot group and 24 weeks in the RV group. There was also a statistically significant difference in median survival between the one-shot group and the RV group (p < 0.01). In the RV group, the 30-day mortality after the initial arterial infusion chemotherapy was 23.1% (3 patients). Two of these 3 patients showed a poor clinical status with uncontrollable ascites at the beginning of this study. In conclusion, arterial infusion chemotherapy through implantable port was evaluated as effective for the treatment of advanced hepatocellular carcinoma in patients with no indication for TAE, but the indication of this therapy remained subject for further evaluation.
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PMID:[Intra-arterial chemotherapy for the treatment of advanced hepatocellular carcinoma through implantable port (reservoir)]. 797 26

One hundred and fourteen consecutive patients with unresectable hepatocellular carcinoma were treated by chemoembolization using ethiodized oil (Lipiodol), anticancer agents. Ninety patients had concomitant chronic liver disease. Hepatocellular carcinoma (HCC) was diagnosed by US, contrast enhanced CT, fine needle biopsy and alpha-feto-protein level. Admission criteria were as follows: tumor confined to the liver with or without hilar nodal involvement, Child class A or B, white blood cell count above 2.000/mmc and platelet count above 75,000/mmc. All the patients underwent angiographic chemoembolization with Lipiodol and anticancer agents. In 98 patients we performed transcatheter hepatic arterial embolization (TAE) with Gelfoam or for Ivalon sponge. In 16 patients TAE was not performed because of portal thrombosis (7 cases) or technical reasons (9 cases). Mitomycin was used in 40 patients and dihydroxyanthracenedione (DADH) in 58 patients. In the TAE group 83 patients were Child A and 15 Child B. In 27 patients HCC was mononodular whereas in 71 it was multinodular. In 41 patients the tumor was more than 5 cm in diameter (in multinodular tumors only the larger lesion was taken into account). In 56 patients chemoembolization plus TAE was repeated. Seven patients died within one month after treatment: two from myocardial infarction, two from liver failure, two from digestive haemorrhage and one from necrotizing pancreatitis. Long-term survival rates were investigated in relation to prognostic factors: anti-cancer agent, number of nodes, tumor size and Child stage using Kaplan-Meier method. Survival rate at 12, 24 and 36 months are 64%, 38%, and 30% respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The treatment of hepatocellular carcinoma by chemoembolization]. 802 66

Supplemental glutamine prevents gut atrophy and enhances muscle protein synthesis in septic rats. This study investigated the effect of glutamine administration and mitomycin C treatment on protein turnover in tumor-bearing rats. AH109A rat ascites hepatoma cells (2 x 10(6)) were subcutaneously implanted in the back of male Donryu rats (n = 32, body weight 150-200 g) on Day 0. The animals were then fed rat chow ad libitum for 10 days. On Day 10, the rats were catheterized for TPN and randomized into four groups according to diet and treatment. The groups were: (i) standard total parenteral nutrition (STPN) + saline; (ii) glutamine-supplemented TPN (GTPN) + saline; (iii) STPN+mitomycin C (MMC); (iv) GTPN+MMC. GTPN was isocaloric (250 kcal/kg/day) and isonitrogenous (1.5 gN/kg/day) with STPN. The animals were maintained on TPN for 5 days and received mitomycin C (0.5 mg/kg) via the catheter every day. On the fifth day of TPN, [1-14C]leucine was given via a 5-hr continuous infusion (2.0 microCi/hr/rat) to determine the fractional synthesis rate of muscle, gut mucosa, liver, and tumor. Also, endogenous leucine production (not equal to whole body protein breakdown rate) was calculated. Body weight loss during TPN was reduced with GTPN. GTPN enhanced muscle FSR in untreated animals (STPN: 10.8 +/- 8.7%/day vs GTPN: 14.7 +/- 0.6%/day, P < 0.05) and in mitomycin C-treated animals (STPN+MMC: 9.6 +/- 0.9%/day, GTPN+MMC: 12.0 +/- 0.8%/day, P < 0.05). The whole body protein breakdown rate was reduced with GTPN. Mitomycin C reduced the mucosal fractional synthesis rate and GTPN did not prevent this reduction.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of glutamine and chemotherapy on protein metabolism in tumor-bearing rats. 804 Nov 29

Hepatoma rarely presents with obstructive jaundice. We describe a case of hepatoma, a 66-year-old woman, presenting with obstructive jaundice, whom we treated with intra-arterial infusion of the anticancer drug, MMC. The hepatic main tumor was situated in the border between the medial and lateral lobe, which caused an obstruction of the common hepatic duct, accompanied with multiple intrahepatic liver metastases. MMC was injected weekly into the reservoir of the Infuse-A-Port, which was located subcutaneously. Intra-arterial infusion therapy reduced the tumor size and tumor markers.
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PMID:[A case of icteric type hepatoma responding to MMC infusion therapy via cannulation into the hepatic artery]. 823 89

In general, chemotherapy does not play an essential role in hepatocellular carcinoma (HCC) because of the low sensitivity to antitumor agents in cancer cells. Additionally, the vast majority of patients with HCC have chronic liver disease, notably cirrhosis, so it is virtually impossible to administer a large amount of antitumor agents. In fact, chemotherapy plays an important part in multimodal treatment for HCC. Whenever chemotherapy is used for patients in the advanced stage, it should be aimed to improve prognosis without impairment of their quality of life. Regarding prognostic factors of chemotherapy for unresectable patients, both reserved hepatic function and tumor advancement are important. Intra-arterial infusion chemotherapy using MMC, ADM, CDDP and/or 5-FU via hepatic artery is appropriately used to improve the therapeutic efficacy. The response rate by one shot injection seems to be approximately 10-20% in general. Although it is not clear which medicine and means of administration are most effective, oral administration is used as a subsidiary treatment for HCC in general. In order to enhance the efficacy of antitumor agents, various drug delivery systems including selective enhancement of tumor blood flow with angiotensin II and drug carriers such as Lipiodol have been applied. Recently, totally implantable arterial access devices have been used for intermittent intra-arterial infusion chemotherapy. It seems to make life easier for the treated patients. Further trials are planned to develop new modes of chemotherapy such as overcoming multidrug resistance by calcium antagonists.
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PMID:[The present status of chemotherapy for hepatocellular carcinoma]. 838 60

We evaluated the effects of intraarterial injection of Adriamycin/Mitomycin C oil (Lipiodol) suspension (ADMOS) alone and ADMOS+cis-diaminodichloroplatinum (CDDP) in 135 patients with hepatocellular carcinoma (HCC). A total of 59 patients received ADMOS alone and 76 patients received ADMOS+CDDP (ADMOS/CDDP). Tumor size was reduced by over 25% in 13 (34%) of the evaluable 38 patients in the ADMOS-alone group and in 39 (51%) of the 76 evaluable patients in the ADMOS/CDDP group. Serum alpha-fetoprotein (AFP) levels decreased by more than 50% in 10 (59%) of 17 ADMOS-alone patients and in 23 (70%) of 33 ADMOS/CDDP patients whose pretreatment AFP levels were above 0.2 mg/l. The overall one- and 2-year survival rates were 68% and 41%, respectively. No severe complications and no significant changes in laboratory values were observed, except for one patient in the ADMOS/CDDP group who developed a liver abscess. Although the tumor response was significantly better in patients treated by ADMOS/CDDP than in those treated by ADMOS-alone (p < 0.05), there was no significant difference in the survival rates between the 2 groups. The intraarterial injection of ADMOS and CDDP was concluded to be effective in treating HCC judging by tumor response.
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PMID:Treatment of hepatocellular carcinoma by intraarterial injection of adriamycin/mitomycin C oil suspension (ADMOS) alone or combined with cis-diaminodichloroplatinum (CDDP). 839 Dec 90

Eighty surgically treated patients with advanced hepatocellular carcinoma (HCC) were divided into two groups. In group I, twenty patients whose mean diameter of tumors was 56 mm, prophylactically underwent hepatic arterial infusion chemotherapy after liver resection. Chemotherapeutic agents (5-FU, ADM, MMC, CDDP, Lipiodol) were administered 4 times a year via Infuse A port. The remaining 60 patients, whose mean diameter of tumors was 57 mm, served as the control without prophylactic infusion (group II). The 2-year cumulative survival rate was higher in the prophylactic group (71%) than the control (48%, p = 0.040). The two-year disease-free survival rate was improved in group I (38%) compared with that in group II (27%, p = 0.021). Intrahepatic multiple recurrence within 1 year after surgery was recognized in four out of 18 patients of group I (22%) and in thirty-three out of 60 patients of group II (55%, p = 0.029). In group I, two cases who died of hepatic failure with no recurrence, had lower functional reverse and a larger amount of Lipiodol than the remaining 18 patients. Adjuvant arterial infusion chemotherapy can thus be be efficacious in alleviating hepatoma recurrence after liver resection. For patients with poor liver function, a smaller volume of chemotherapeutic agents might be feasible.
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PMID:[Clinical evaluation of postoperative adjuvant arterial infusion chemotherapy in resected hepatoma patients]. 839 1

Frequent chemolipiodolization and prostaglandin E1 (PGE1) administered through a hepatic arterial infusion port were used for treatment in 2 cases of hepatocellular carcinoma (HCC) with liver cirrhosis. Chemolipiodolization was performed every 4 weeks with 6 ml lipiodol, 3 ml Optilay and 30 mg Epirubicin or 10 mg Mytomycin C. PGE1 (10 ug) was administrated to the hepatic artery once every week after the first 7 days administration. The treatment resulted in a decrease of the AFP level, an arrest of HCC growth and a reduction in ascites with an improvement of clinical and biochemical parameters in both cases. These encouraging preliminary results show that frequent lipiodolization is effective for unresectable HCC and frequent PGE1 administration via the hepatic artery is a safe and efficient treatment for liver cirrhosis.
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PMID:Chemolipiodolization and prostaglandin E1 administration with use of hepatic arterial infusion port for the treatment of hepatocellular carcinoma and liver cirrhosis. 890 77

It was reported that sodium thiosulfate (STS) was contributed to antivomiting effect in 20 transarterial chemotherapic patients. The antitumor sensitivity of STS (< 500 micrograms/ml) adjuncting to the ADM, MMC, CDDP and other four agens (1 x PPC/ml) individually on two tumor cells studied by MTT test in vitro and no antitumor activity of adjuvant of STS were obviously obliterated (P > 0.05) except for CDDP clinically, to comparing the adjuncting effects of STS (iv. 30 min ahead) or metochlopramidum (im. 30 min ahead) to ADM, MMC and CDDP on HCC (40 cases), the degrees of vomiting in hepatoma patient after transcatheter arterial chemoem bolization with ADM, MMC and CDDP were statisticaly analysec. It have been proven that STS was contributed to the low incidence of vomiting and superior to metocloe pramidum, without worsening of the chemotherapy of HCC. It is worth futher studying adjuvant STS to other antitumor drugs and exploring potential application of chematherapy in cancer.
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PMID:[Relieving effect of sodium thiosulfate on transarterial chemotherapeutic emesis]. 930 80


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