A pilot study of transcatheter arterial interferon embolization for patients with hepatocellular carcinoma.
Systemic, high-dose interferon-alpha treatment given three times per week subcutaneously induces tumor regression in approximately 30% of patients with inoperable hepatocellular carcinoma (HCC). The objective of the current study was to determine the efficacy and safety of transcatheter arterial interferon embolization for the treatment of patients with inoperable HCC. Eighteen patients with inoperable HCC were recruited to receive 3 different doses of interferon-alpha-2b (10 megaunits [MU]/m(2), 30 MU/m(2), or 50 MU/m(2)) at intervals of 8-12 weeks. Their tumor response, adverse events, and survival were monitored. In 14 patients with nondiffuse HCC, complete responses and partial responses (> 50% tumor reduction) were observed in 28.6% and 35.7% of patients, respectively. One of four patients with diffuse HCC had a partial response. Thirty-eight percent of patients had normalization of their alpha-fetoprotein level. The median ferritin level at the last follow-up was reduced significantly (765 pmol/L; range, 457-2720 pmol/L) compared with the baseline level (1980 pmol/L; range, 1100-3300 pmol/L; P = 0.011). The median survival was 15.9 months. Transient fever and rigor were the most common side effects observed. Five patients (27.8%) developed hypothyroidism. No significant liver decompensation was observed. This pilot study showed that transcatheter arterial interferon embolization was an effective method for the treatment of patients with inoperable HCC without significant hepatic toxicity.