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Chemoembolization for hepatocellular carcinoma.

A P Venook1, R J Stagg, B J Lewis

  • 1Department of Radiology, University of California, San Francisco 94143.

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
|June 1, 1990
PubMed
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Chemoembolization using Gelfoam demonstrated significant activity in treating unresectable hepatocellular carcinoma (HCC). This treatment showed notable response rates and was relatively well tolerated by patients with liver cancer.

Area of Science:

  • Hepatology
  • Interventional Radiology
  • Oncology

Background:

  • Hepatocellular carcinoma (HCC) is a primary liver cancer with limited treatment options for unresectable cases.
  • Chemoembolization offers a potential therapeutic approach for managing advanced HCC.

Purpose of the Study:

  • To evaluate the efficacy and safety of Gelfoam chemoembolization in patients with unresectable HCC.
  • To assess treatment response, survival, and complications associated with this procedure.

Main Methods:

  • Fifty-one patients with unresectable HCC underwent chemoembolization via hepatic artery catheterization.
  • A mixture of Gelfoam, contrast media, and chemotherapy drugs (doxorubicin, mitomycin, cisplatin) was injected.
  • Treatment response was assessed using conventional criteria, CT scans, and alpha-fetoprotein (AFP) levels.

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Main Results:

  • Objective responses (partial and minor) were observed in 50% of assessable patients.
  • Tumor liquefaction occurred in 70% of patients, and 68% of those with elevated AFP showed >50% reduction.
  • Median survival was 207 days from treatment initiation; 14 patients survived from 3 months to 3 years.
  • Common toxicities included transient pain, fever, nausea, and elevated liver enzymes; two treatment-related deaths occurred.

Conclusions:

  • Gelfoam chemoembolization exhibits significant therapeutic activity in unresectable HCC.
  • The procedure is relatively well tolerated, with manageable side effects and a notable impact on tumor burden and survival.
  • This approach represents a viable option for managing advanced hepatocellular carcinoma.