高度進行肝細胞癌に対する放射線併用動注化学療法の有用性

OBJECTIVE : The purpose of this study is to assess the treatment outcomes and adverse effects of concurrent chemotherapy and radiotherapy for hepatocellular carcinoma with portal vein tumor thrombus.
METHODS : Twelve unresectable hepatocellular carcinoma patients with portal vein tumor thrombosis were treated using concurrent chemotherapy and radiation therapy. Four patients received transcatheter arterial chemoembolization using miriplatin-lipiodol suspension. Eight patients received interferon-α (IFN) and 5‐fluorouracil (5‐FU) combination therapy. The total radiation dose was 30‐50Gy. The response rate and overall survival and the toxicity were analyzed.
RESULTS : Concurrent chemotherapy and radiotherapy was associated with a 50.0% objective response rate for primary tumors (miriplatin-lipiodol : 50.0%, IFN‐5FU : 50.0%). And a 66.7% objective response rate for portal vein tumor thrombus (miriplatin-lipiodol : 75.0%, IFN‐5FU : 62.5%). The median survival was 273 days (miriplatin-lipiodol : 273 days, IFN‐5FU : 262 days). Myelosuppression was observed in two patients, but no treatment-related deaths were observed.
CONCLUSIONS : The present results suggest concurrent chemotherapy and radiotherapy is a practical and safe treatment option in hepatocellular carcinoma patients with extensive portal vein tumor thrombus.