| [ Summary ] |
Systemic chemotherapy for hepatocellular carcinoma (HCC) has been of limited value in clinical practice, because only a small percentage of patients receive significant benefits, and because the toxicity of chemotherapy often outweighs the benefits. Therefore, at present, only HCC patients with no indications for standard treatments undergo chemotherapy. In this chapter, we described the present status of chemotherapy for HCC, and examined the prognoses for HCC patients who underwent chemotherapy in our hospital. Those who responded to chemotherapy had significantly greater survival rates than nonresponders. Therefore, if agents with higher response rates were developed, their use could improve the prognoses for patients with HCC. The analysis of the relationship between patients' characteristics and tumor responses revealed that there were no responders among patients with jaundice, ascites, a performance status (PS) of 2-3, or tumor thrombus in the main portal trunk. As to the relationship between patients' characteristics and prognosis, a PS of 2-3, tumor thrombus in the main portal trunk, and age over 60 were found to be independent unfavorable prognostic factors. These findings indicate that patients with poor hepatic reserves and/or greatly advanced HCC are inappropriate candidates for chemotherapy. |