Combination chemotherapy and radiation for palliation of hepatocellular carcinoma.

Twenty seven patients with hepatocellular carcinoma were treated by sequential methotrexate (75 mg/m2) and 5-fluorouracil (5-FU) (750 mg/m2) on day 1 followed on days 8-36 by external beam radiotherapy (total dose 30 cGy). The response was assessed by liver size on clinical examination. One patient had complete response, and six patients had partial response. The overall response to the treatment was 25.9%. More than a 50% reduction in serum alfa-fetoprotein level was noted in 66.6% patients. Seventy-one percent of patients had palliation of pain following therapy. The median survival of responders was 11 months and of nonresponders, 2 months. Radiation was discontinued in two patients who developed radiation hepatitis. Additional trials with different dosages and schedules are needed to fully evaluate this form of therapy.