[Treatment of elderly patients with hepatocellular carcinomas with mitomycin C and 5-fluorouracil]

Twenty elderly patients with hepatocellular carcinoma were treated with 5-fluorouracil (5-FU) at a daily dose of 200-300 mg per os, and with a combination of 0.3-0.35 mg/kg of mitomycin C (MMC) iv on day 1 and 8-10 mg/kg of 5-FU iv daily starting on day 1 for 5 consecutive days, repeating at 4 week intervals. According to the Koyama-Saito's criteria, there was no response in the 5-FU treatment, while a 20% (2/10) of response rate (2 partial responses) was obtained in the combination regimen. The durations of response in 2 partial responses were 7.3 and 4.0 months, respectively. The median survival with MMC and 5-FU was 3.4 months compared with 1.5 months with 5-FU alone, and the survival was correlated with tumor response. The combination produced more gastrointestinal toxicities and myelotoxicities compared to a single drug, but they were well tolerated. These results support the superiority of the combination of MMC and 5-FU over 5-FU alone in the treatment of elderly hepatocellular carcinoma.