Development of a new multi-modality therapy for far advanced hepatocellular carcinoma : a combined therapy of a new percutaneous local tumor ablation and a chemotherapy using subcutaneously embedded port for arterial infusion or gene therapy

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The aim of this study was to develop a new multi-modality therapy for far advanced hepatocellular carcinoma, which had been treated non-curatively only by transcatheter arterial embolization or supportive therapy because of wide spread of the cancer. We wanted to develop a combined therapy of a new percutaneous local tumor ablation and a chemotherapy using subcutaneously embedded port for arterial infusion or gene therapy.With regard to development of a new percutaneous tumor ablation, we have performed radio-frequency ablation(RFA)on a total of 400 cases since we introduced it in February 1999. In RFA, we can surely obtain a necrotic area of 3 cm in diameter by a 12-minute ablation. In most cases, one or two treatment sessions are enough to achieve a complete necrosis of the lesion with a safety margin, which results in a shorter hospitalization. We think more than 95% of cases treated by percutaneous tumor ablation will be treated by RFA in the near future. Thus we would like to gain more know-how to perform RFA.With regard to optimization of chemotherapy, we performed "low dose FP" chemotherapy using subcutaneously embedded port for arterial infusion and have been analyzing data to evaluate factors which contributed the chemotherapeutic efficacy. The final goal is to predict therapeutic efficacy before the treatment. To do this, we would use DNA tips in the future. We have also used a new chemotherapeutic regimen of 5-FU and interferon. We will use the regimen on more cases and evaluate its efficacy.We have used nude mice to examine usefulness and safety of a gene therapy in order to introduce it to a clinical trial. However, we have not achieved satisfactory results yet.