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

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

Research output: Contribution to journalArticle

24 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)201-206
Number of pages6
JournalMedical Oncology
Volume25
Issue number2
DOIs
Publication statusPublished - Jun 2008
Externally publishedYes

Fingerprint

Leucovorin
Etoposide
Fluorouracil
Doxorubicin
Cisplatin
Hepatocellular Carcinoma
Drug Therapy
Therapeutics
Survival
Neutropenia
Thrombocytopenia
Vomiting
Anemia
Diarrhea
Appointments and Schedules
Bone Marrow
Confidence Intervals
Kidney
Liver

Keywords

  • 5-fluouracil
  • Cisplatin
  • Doxorubicin
  • Etoposide
  • Hepatocellular carcinoma
  • Leucovorin

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Hematology

Cite this

Chemotherapy with etoposide, doxorubicin, cisplatin, 5-fluorouracil, and leucovorin for patients with advanced hepatocellular carcinoma. / Yuan, Jeng Nian; Chao, Yee; Lee, Wei Ping; Li, Chung Pin; Lee, Rheun Chuan; Chang, Full Young; Yen, Sang Hue; Shou-Dong, Lee; Whang-Peng, Jacqueline.

In: Medical Oncology, Vol. 25, No. 2, 06.2008, p. 201-206.

Research output: Contribution to journalArticle

Yuan, Jeng Nian ; Chao, Yee ; Lee, Wei Ping ; Li, Chung Pin ; Lee, Rheun Chuan ; Chang, Full Young ; Yen, Sang Hue ; Shou-Dong, Lee ; Whang-Peng, Jacqueline. / Chemotherapy with etoposide, doxorubicin, cisplatin, 5-fluorouracil, and leucovorin for patients with advanced hepatocellular carcinoma. In: Medical Oncology. 2008 ; Vol. 25, No. 2. pp. 201-206.
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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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T1 - Chemotherapy with etoposide, doxorubicin, cisplatin, 5-fluorouracil, and leucovorin for patients with advanced hepatocellular carcinoma

AU - Yuan, Jeng Nian

AU - Chao, Yee

AU - Lee, Wei Ping

AU - Li, Chung Pin

AU - Lee, Rheun Chuan

AU - Chang, Full Young

AU - Yen, Sang Hue

AU - Shou-Dong, Lee

AU - Whang-Peng, Jacqueline

PY - 2008/6

Y1 - 2008/6

N2 - 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.

AB - 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.

KW - 5-fluouracil

KW - Cisplatin

KW - Doxorubicin

KW - Etoposide

KW - Hepatocellular carcinoma

KW - Leucovorin

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