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KMID : 1103920110170020120
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Korean Journal of Hepatology
2011 Volume.17 No. 2 p.120 ~ p.129
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Combination treatment with intrahepatic arterial infusion and intratumoral injection chemotherapy in patients with far-advanced hepatocellular carcinoma and arterioportal or arteriovenous shunts: preliminary results
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Kim Ja-Seon
Park Young-Min
Kim Nha-Young
Yun Han-Kyeol
Lee Ki-Jong
Kim Bo-Hyun
Park Sang-Jong
Yeon Jae-Woo
Jung Gu-Hung
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Abstract
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Background/Aims: Combination treatment consisting of hepatic arterial infusion chemotherapy with epirubicin and cisplatin (HAIC-EC) and systemic infusion of low-dose 5-fluorouracil (5-FU) are sometimes effective against advanced hepatocellular carcinoma (HCC). However, there is no effective treatment for advanced HCCs with arterioportal shunts (APS) or arteriovenous shunts (AVS).
Methods: We investigated a response and adverse events of a new combination protocol of repeated HAIC-EC and percutaneous intratumoral injection chemotherapy with a mixture of recombinant interferon-gamma (IFN-γ) and 5-FU (PIC-IF) in patients with far-advanced HCCs with large APSs or AVSs.
Results: There was a complete response (CR) for the large vascular shunts in all three patients and for all tumor burdens in two patients. Significant side effects were flu-like symptoms (grade 2) and bone marrow suppression (grade 2 or 3) after each cycle, but these were well-tolerated.
Conclusions: These results suggest that the combination of HAIC-EC and PIC-IF is a new and promising approach for advanced HCC accompanied by a large APS or AVS.
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KEYWORD
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Hepatocellular carcinoma, Arterioportal shunt, Intratumoral injection chemotherapy, Interferon-gamma
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