Clinical Study Of Combination Chemotherapy Based On CPT-11 On Hepatocellular Carcinoma

Objective: This study explore the effect and adverse reaction of combination chemotherapy based on CPT-11 ,the new cytotoxicity drug,on hepatocellular carcinoma.Materials and methods: From September 2004 to March 2007, the twenty-one patients were diagnosed with advanced and un-resectable hepatocellular carcinoma(HCC)in oncology department of the second affiliated hospital of DaLian Medical University. The median age is 56 and the karuafsky score > 60, the anticipate survival time> 3 months and hepatic function is normal. The therapy with CPT-11 combinated with 5Fu and DDP was : 11 cases were given with CPT-11 100mg,5Fu 1000mg and DDP 60mg through hepatic arterial infusion (group A), d1, 21～28 days a cycle; 10 cases were given with CPT-11 100mg d1,8,15,in vein drop and 5Fu 300mg/d d1～7,in persistently drop(group B), 21～28 days a cycle;44cycles were done. The evaluation standard include: response rate (by RECIST),clinical benefit response CBR(CR+PR+SD),the decrease rate of AFP(the decrease of AFP exceed 50% than pre-therapy is positive),mTTp,adverse reaction(by NCI 3.0).Results: All of patients could be evaluated. The overall response was 4.8%, CBR was 80%,the decrease rate of AFP was 33.3% and mTTP was 5months. 11 cases of group A given through hepatic arterial infusion were all evaluated as SD . The clinical benefit rate (CBR) was 100%, the decrease rate of AFP was 50%, mTTP was 5 months; 10 cases of group B were given through vein with results of PR 1 case(10%) and SD 5 case (50%). The clinical benefit rate (CBR) was 60%, the decrease rate of AFP was 20%, mTTP was 5 months too. The incidence rate of adverse reaction were: bone marrow depression was 76.2%(Ⅰ°,Ⅱ°were 52.3%), hepat-toxicity was 52.4%(Ⅰ°,Ⅱ°were 42.3%), tardive diarrhea was 23.8%(Ⅰ°,Ⅱ°were 19.1%), these of group A and group B were: 54.5%,36.3%,18.1% and 100%,70%,30%. 1 case happenedⅣ0 hepat-toxicity and died with acute serious hepatitis.This chemotherapy has some advantages on CBR and mTTP with slight adverse reaction.Conclusoins: 1. The combination chemotherapy based on CPT-11 is effective in the treatment of patients with HCC is equivalent effective with conventional therapy and has some advantages on CBR and mTTP but the toxicities are tolerable, so it may be a new choice of chemotherapy on HCC.2. The combination chemotherapy based on CPT-11 through HAI is better than through vein on HCC because of higher CBR, lower incidence rate of adverse reaction and equivalent mTTP. But for patients with advanced HCC or inability through HAI, this chemotherapy through vein is effective.3. Further study with more cases should be done .