Gemcitabine Based Combination Treatment For Hepatocellular Carcinamo

Objective:The aim of this study is to review the clinical efficacy and toxicity of gemcitabine based combination treatment with advanced hepatocellular carcinamo(HCC).Materials and Methods:From January 1st 2002 to December 30st 2009, 65 patients with advanced HCC,which diagnosed based on histology or by World Health Organization (WHO) criteria and losed the operation and intervention opportunity, admitted into the tumor hospital of guangxi and treated with gemcitabine based combination regimen. We collected and analysed their records. Assessment of response both based on computer tomography or ultrasonography was performed after every 1 cycle of chemotherapy. Evaluation of adverse reactions based on WHO standards.Results:64 patients were assessable for efficacy and all patients for toxicity. The objective response rate and disease control rate were 6.3% and 50.0%. The median overall survival for 60 patients was 5.6 months (95%CI:4.190～7.010).The 6-month,1-year and 2-year survival rates were 48.3%,26.7% and 3.3%, respectively. The ORR of phase 3 and phase 4 were 6.1%,6.5% (P=1.000), DCR were 51.5%,48.4% (P= 0.802).The median overall survival of the two phases were 6.5 months and 4.5 months, respectively (P=0.054).The 6-month,1-year and 2-year survival rates were 58.1% and 37.9%,38.7% and 17.2%,3.3% and 6.5%, respectively.Toxicities were well managed.29 patients were assessable for efficacy and all patients for toxicity in the GEM plus UFT regimen. The ORR and DCR were 10.3% and 48.3%, respectively.The median overall survival was 5.8 months.The 6-month,1-year and 2-year survival rates were 48.3%,26.7% and 3.3%, respectively.In the comparative analysis of GEM plus UFT regimen and GEM plus L-OHP regimen, the ORR were 10.3%,2.9%(P= 0.321), DCR were 48.3%, 51.4%(P=0.802). The median overall survival of the two regimens were 5.8 months and 5.6 months, respectively.The 6-months,1-year and 2-year survival rates were 48.1% and 48.5% (P= 0.979),33.3% and 21.2% (P= 0.291),3.7% and 3.0% (P= 1.000), respectively.There was not different from two survival curves (P= 0.826).Conclusions:1.Gemcitabine based combination treatment has low efficiency in the treatment for advanced HCC, but DCR were 50.0%, so it may has certain clinical efficiency, and has a tolerated adverse reactions.2. Gemcitabine plus uracil-tegafur regimen has certain clinical efficiency, and has a tolerated adverse reactions.3.The efficacy of GEM plus UFT regimen and GEM plus L-OHP regimen was not different.