Risk factors for side effects of long-term administration of 5-fluorouracil derivatives in patients with hepatocellular carcinoma associated with liver cirrhosis

relationship with serum concentration of anti-tumor agents and side effect

Abstract

Side effects of long-term administration of 5-FU derivatives were investigated in 52 patients with hepatocellular carcinoma treated by transcatheter arterial embolization (TAE) therapy. Almost patients (48/52) were associated with liver cirrhosis. Patients were classified into two groups as follows: 27 patients with tegafur 600mg/day administration after TAE (group A), and 25 with UFT (compound of tegafur 400mg/day and uracil) administration after TAE (group B).
Twenty-four patients could take antitumor drugs more than one month in group A, and 23 in group B. Newly appeared ascites and/or encephalopathy within 6 months were common in both groups: 8/24 (33.3%) in gorup A, and 7/23 (30.4%) in group B. Bilirubin and coagulation tests were significantly aggravated about 6 months after the drug therapy.
Aggravation of liver function were more frequently observed in patients whose age were more than 55 and whose ICG R15 value were more than 30%. Study of serum concentration of antitumor drugs after 3-5 months administration showed that appearance rate of ascites and/or encephalopathy within 6 months were significantly higher in patients with high 5-FU concentration more than 12pg/ml. Long term use of anticancer drugs may worsen liver reserves, and these drugs should be cautiously administered for hepatocellular carcinoma associated with liver cirrhosis.