Chemotherapy with etoposide,doxorubicin, cisplatin, 5-fluorouracil,and leucovorin for patients with advanced hepatocellular carcinoma |
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Authors: | Jeng-Nian Yuan Yee Chao Wei-Ping Lee Chung-Pin Li Rheun-Chuan Lee Full-Young Chang Sang-Hue Yen Shou-Dong Lee Jacqueline Whang-Peng |
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Affiliation: | Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, 201, Sec 2, Shih-Pai Road, Taipei 11217, Taiwan. |
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Abstract: | BACKGROUND: To investigate the therapeutic index of combining etoposide, doxorubicin (adriamycin), cisplatin, 5-fluorouracil (5-FU), and leucovorin (EAPFL) chemotherapy in the treatment of advanced HCC, a trial of a novel schedule of triweekly administration was conducted. PATIENTS AND METHODS: Sixty-six patients with measurable advanced HCC, adequate liver and renal functions and adequate bone marrow reserves in whom local treatment was not indicated were studied. Triweekly EAPFL treatment consisted of a concomitant boost of etoposide 40 mg/m2 i.v. over 30 min on day 1, 2, and 3, doxorubicin 30 mg/m2 i.v. over 30 min on day 1 to a backbone regimen, triweekly PFL chemotherapy with cisplatin 60 mg/m2, 5-FU 1,200 mg/m2, and leucovorin 120 mg/m2 given simultaneously by a 72-h i.v. infusion. Response, survival, and toxicity were evaluated. RESULTS: One patient had complete response (1%) and thirteen patients had partial response (20%). The objective response rate was 21% (95% confidence interval 11-31%). The median overall survival and median time to progression were 8.9 months and 3.3 months, respectively. Major treatment toxicities (grade 3-4) were neutropenia (28%), anemia (11%), thrombocytopenia (7%), hepatotoxicity (5%), vomiting (2%), and diarrhea (2%). There was no treatment-related death. CONCLUSION: Triweekly EAPFL chemotherapy is a moderately effective regimen with tolerable toxicities in the treatment of advanced HCC. |
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Keywords: | Hepatocellular carcinoma Etoposide Doxorubicin Cisplatin 5-fluouracil Leucovorin |
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