Treatment of hepatocellular carcinoma (HCC) with systemic chemotherapy combining epirubicin, cisplatinum and infusional 5-fluorouracil (ECF regimen)

HeadingAbstractPurpose. We tested the efficacy of a systemic chemotherapy regimen combining epirubicin, cisplatinum and infusional 5-fluorouracil (ECF) in a cohort of patients with hepatocellular carcinoma (HCC) who could not be given surgical, intraarterial or percutaneous treatment.Patients and methods. Between January 1998 and June 2000, 21 patients with metastatic and/or locally advanced HCC complicating a fibrous liver or a well-compensated (Child A) cirrhosis were given systemic chemotherapy with the ECF regimen. Tumor responses as assessed on CT scan and in terms of survival were studied.Results. Patients completed a median of five chemotherapy courses. Overall tolerance was good but eight patients developed grade 3-4 toxicity, mainly hematological, and one patient experienced a grade 4 renal toxicity. Median survival was 10 months. Actuarial survivals (±SD) at 6 months, 1 year and 2 years were 90.2±9%, 70.3±10% and 24.6±19%, respectively. Of the 21 patients, 13 died, 12 from their tumor and 1 from treatment-related renal failure. There were only three objective responses (14.5%; CI95 1–28%) but one of these corresponded to a pathological complete response. The delay to tumor progression was 5.9±4.7 months.Conclusions. Systemic chemotherapy using the ECF regimen gave a poor response and low survival rates. It would appear reasonable to pursue the search for potentially efficacious chemotherapy protocols using other drug combinations.