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Chemotherapy with etoposide, doxorubicin, cisplatin, 5-fluorouracil, and leucovorin for patients with advanced hepatocellular carcinoma

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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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Acknowledgements

This work was supported by grant no. TVGH 91-196 from the Taipei Veterans General Hospital, Taipei, Taiwan.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, 201, Sec 2, Shih-Pai Road, Taipei, 11217, Taiwan

    Jeng-Nian Yuan, Wei-Ping Lee, Chung-Pin Li, Full-Young Chang & Shou-Dong Lee

  2. National Yang-Ming University School of Medicine, Taipei, Taiwan

    Jeng-Nian Yuan, Yee Chao, Wei-Ping Lee, Chung-Pin Li, Rheun-Chuan Lee, Full-Young Chang, Sang-Hue Yen & Shou-Dong Lee

  3. Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan

    Yee Chao & Sang-Hue Yen

  4. Central Clinic Hospital, Taipei, Taiwan

    Yee Chao

  5. Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan

    Rheun-Chuan Lee

  6. Cancer Research Institute, National Health Research Institute, Taipei, Taiwan

    Jacqueline Whang-Peng

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  1. Jeng-Nian Yuan
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Correspondence to Chung-Pin Li.

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Yuan, JN., Chao, Y., Lee, WP. et al. Chemotherapy with etoposide, doxorubicin, cisplatin, 5-fluorouracil, and leucovorin for patients with advanced hepatocellular carcinoma. Med Oncol 25, 201–206 (2008). https://doi.org/10.1007/s12032-007-9013-3

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  • DOI: https://doi.org/10.1007/s12032-007-9013-3

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