Uka K, Aikata H, Takaki S, Kawaoka T, Saneto H, Miki D, Takahashi S, Toyota N, Ito K, Chayama K. Systemic gemcitabine combined with intra-arterial low-dose cisplatin and 5-fluorouracil for advanced hepatocellular carcinoma: Seven cases. World J Gastroenterol 2008; 14(16): 2602-2608 [PMID: 18442216 DOI: 10.3748/wjg.14.2602]
Corresponding Author of This Article
Hiroshi Aikata, MD, Department of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 7348551, Japan. aikata@hiroshima-u.ac.jp
Article-Type of This Article
Case Report
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Kiminori Uka, Hiroshi Aikata, Shintaro Takaki, Tomokazu Kawaoka, Hiromi Saneto, Daiki Miki, Shoichi Takahashi, Kazuaki Chayama, Department of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 7348551, Japan
Naoyuki Toyota, Katsuhide Ito, Department of Radiology, Hiroshima University Hospital, Hiroshima 7348551, Japan
Author contributions: Uka K and Aikata H contributed equally to this work; Uka K and Aikata H designed the research; Uka K and Aikata H performed the research; Uka K and Aikata H analyzed the data; and Uka K and Aikata H wrote the paper.
Correspondence to: Hiroshi Aikata, MD, Department of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 7348551, Japan. aikata@hiroshima-u.ac.jp
Telephone: +81-82-2575192
Fax: +81-82-2575194
Received: November 16, 2007 Revised: January 24, 2008 Published online: April 28, 2008
Abstract
The combination of intra-arterial low-dose cisplatin and 5-fluorouracil (5-FU) is effective against advanced hepatocellular carcinoma (HCC). Systemic gemcitabine chemotherapy seems effective in many cancers. We report the results of combination therapy with systemic gemcitabine, intra-arterial low-dose cisplatin and 5-FU (GEMFP). Seven patients with non-resectable advanced HCC were treated with GEMFP. One course of chemotherapy consisted of daily intra-arterial cisplatin (20 mg/body weight/hour on d 1, 10 mg/body weight per 0.5 h on d 2-5 and 8-12), followed by 5-FU (250 mg/body weight per 5 h on d 1-5 and 8-12) via an injection port. Gemcitabine at 1000 mg/m2 was administered intravenously at 0.5 h on d 1 and 8. The objective response was 57%. The response to GEMFP was as follows: complete response (no patients), partial response (four patients), stable disease (three patients), and progressive disease (no patients). The median survival period was 8 mo (range, 5-55). With regard to the National Cancer Institute Common Toxicity Criteria (NCI-CTC) grade 3 or 4 adverse reactions, seven (100%), seven, six (86%) and one (14%) patients developed leukopenia, neutropenia, thrombocytopenia and anemia, respectively. GEMFP may potentially be effective for non-resectable advanced HCC, but it has severe hematologic toxicity.
