Low-dose cisplatin plus oral tegafur and uracil for the treatment of lung metastases of hepatocellular carcinoma.

BACKGROUND/AIMS: An effective treatment for unresectable multiple lung metastases of hepatocellular carcinoma have never been established. METHODOLOGY: Six patients received the chemotherapy described herein as an initial treatment for lung metastases of hepatocellular carcinoma. Low-dose cisplatin infusion plus oral tegafur and uracil administration combination therapy essentially consisted of cisplatin (10 mg/day over 1 hour) infused on days 1-5 every week and oral tegafur and uracil (300 mg/day) administrated every day. This treatment was repeated weekly for essentially 4 consecutive weeks. RESULTS: Complete response was observed in no cases and partial response in 3 cases, while no change was observed in 4 cases and progressive disease in one case. An overall response rate was 50%. The serum alpha-fetoprotein and des-Y-carboxyprothrombin were reduced in most of the patients. Leukopenia of grade 2 was observed in only 1 (17%) patient. Thrombocytopenia of grade 2 was observed in 2 (33%) patients. Nausea (up to Grade 2) was occurring in 4 (67%) patients. Three patients with no other distant metastasis survive more than two years after lung metastasis, and the quality of life of these patients are well preserved. CONCLUSIONS: Low-dose cisplatin infusion combined with oral tegafur and uracil administration for the treatment of lung metastases of hepatocellular carcinoma may be an effective regimen with a high response rate and acceptable toxicities, although a larger study will be necessary to confirm the efficacy.

New method of catheter-port system implantation in hepatic arterial infusion chemotherapy.

BACKGROUND: This report describes a novel method of implantation of the catheter-port system in hepatic arterial infusion chemotherapy, which is the inferior epigastric arterial approach. METHODS: Using this method, the length of incision is about 3 cm in lower abdomen. The inferior epigastric artery is exposed above the inguinal ligament. The half of the artery is cut, and a vascular sheath is inserted into the external iliac artery along a guide wire. A catheter is inserted into the hepatic artery through the vascular sheath. Coil occlusion of nontarget artery is performed by the technique of interventional radiology. Then the vascular sheath is removed and the catheter is fixed to the inferior epigastric artery. A port is connected to the catheter and placed above the incision in the lower abdomen. CONCLUSIONS: Using this method, the hip joint can be moved freely and port-related complications are few, which contributes to a good quality of life of patients during the therapy. The inferior epigastric arterial approach may give a benefit to those who are treated with hepatic arterial infusion chemotherapy.