Salvage therapy for hepatocellular carcinoma with thalidomide

来源 :World Journal of Gastroenterology | 被引量 : 0次 | 上传用户:chenaabb1111
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AIM:To evaluate the clinical benefit of thalidomide in patientswith advanced hepatocellular carcinoma (hepatoma).METHODS:From March 2000 to July 2002,patients whohad advanced hepatocellular carcinoma and failed to or wereunsuited for aggressive treatment,were enrolled and tookthalidomide 150 to 300 mg/d.All cases were followed tillApril 2003.Data collection included viral hepatitis,grade ofcirrhosis,total dosage of thalidomide,side effect,stage ofhepatoma by Okuda and CLIP classification,and prognosis.The subjects were divided into A and B groups,dependingon 5000mg dosage of thalidomide.Survival time of allcases and in the two subgroups was evaluated.RESULTS:Ninety-nine patients with hepatoma were enrolled,81 men and 18 females with median age 58±14.1 years.Eighty-six percent had viral hepatitis and one case wasalcoholism.Hepatoma was diagnosed with histology,alpha-fetoprotein (aFP)>400ng/mL,or image examination,therewere 30,33 and 36 cases respectively.At the time ofthalidomide therapy,more than 81% had cirrhotic status.Twenty-two patients were in group A (<5000mg) withmedian survival time about 25 days,for 77 cases in group B(≥5000mg) the median survival time was about 109 days.Six subjects had partial response.Most adverse effects wereskin rush,neuropathy,somnolence,and constipation.CONCLUSION:Several patients responded to thalidomidetherapy.As a single drug therapy,thalidomide might nothave good therapeutic effect for all cases,but a small ratioof patients had exciting response,the resistance or tumorescape would develop after long-term use.Up to now,nodefined facts could be used to predict response.The effectof thalidomide on hepatoma might be associated with thedosage.As salvage therapy,thalidomide has its value.Combination or adjuvant therapy will be the next trial. AIM: To evaluate the clinical benefit of thalidomide in patients with advanced hepatocellular carcinoma (hepatoma). METHODS: From March 2000 to July 2002, patients who had advanced hepatocellular carcinoma and failed or were administered for aggressive treatment, were enrolled and took thalidomide 150 to 300 mg / d. All cases were followed till April 2003. Data collection included viral hepatitis, grade ofcirrhosis, total dosage of thalidomide, side effect, stage of hepatoma by Okuda and CLIP classification, and prognosis. The subjects were divided into A and B groups, dependingon 5000mg dosage of thalidomide. Survival time of allcases and in the two subgroups was been. RESULTS: Ninety-nine patients with hepatoma were enrolled, 81 men and 18 females with median age 58 ± 14.1 years. Empy-six percent had viral hepatitis and one case was alcoholism .Hepatoma was diagnosed with histology, alpha-fetoprotein (aFP)> 400 ng / mL, or image examination, therewere 30,33 and 36 cases respectively. At the time ofthalidomide thera py, more than 81% had cirrhotic status.Twenty-two patients were in group A (<5000mg) with median survival time about 25 days, for 77 cases in group B (≥5000mg) the median survival time was about 109 days. Had partial response. More adverse effects wereskin rush, neuropathy, somnolence, and constipation. CONCLUSION: Several patients responded to thalidomide therapy. As a single drug therapy, thalidomide might not good therapeutic effect for all cases, but small proportion of patients had exciting response, the resistance or tumorescape would develop after long-term use. Up to now, nodefined facts could be used to predict response. the effectof thalidomide on hepatoma might be associated with thedosage. As salvage therapy, thalidomide has its value .Combination or adjuvant therapy will be the next trial.
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