Systemic chemo-immunotherapy for advanced-stage hepatocellular carcinoma

AIM: To evaluate the therapeutic efficacy of systemic chemoimmunotherapy for advanced hepatocellular carcinoma (HCC). METHODS: Twenty-six patients with advanced HCC were treated by using systemic chemo-immunotherapy (PIAF regimen), which consisted of cisplatin (20 mg/m(2)) intravenously daily for 4 consecutive day, doxorubicin (40 mg/m(2)) intravenously on day 1, 5-fluorouracil (400 mg/m(2)) intravenously daily for 4 consecutive day, and human recombinant a-interferon-2a (5 Mu/m(2)) subcutaneous injection daily for 4 consecutive day. The treatment was repeated every 3 wk, with a maximum of six cycles. RESULTS: A total of 90 cycles of PIAF treatment were administered, with a mean number of 3.9 cycles per patient. Eight patients received six cycles of treatment (group A), and the remaining 18 were subjected to two to five cycles (group B). There were 0 complete response, 4 partial responses, 9 static diseases and 13 progressive diseases, with a disease control rate of 50% (13/26). The 1-year survival rate was 24.3%, with a median survival time of 6.0 mo. Group A had a remarkably better survival as compared with group B, the 1- and 2-year survival rates were 62.5% vs 6.1% and 32.3% vs 0%, and a median survival time was 12.5 mo vs 5.0 mo (P = 0.001). CONCLUSION: Systemic chemo-immunotherapy using PIAF regimen represented an effective treatment and could improve the survival rate and prolong the survival time in selected patients with advanced HCC. (C) 2005 The WJG Press and Elsevier Inc. All rights reserved.