J Med Assoc Thai 2008; 91 (10):1539

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The Effect of Doxorubicin on the Changes of Serum Vascular Endothelial Growth Factor (VEGF) in Patients with Hepatocellular Carcinoma after Transcatheter Arterial Chemoembolization (TACE)
Leelawat K Mail, Laisupasin P , Kiatdilokrut A , Pongtongpool T , Narong S , Samkhumphim N , Ket-Horm S

Background: Treatment of hepatocellular carcinoma (HCC) with transcatheter arterial chemoembolization
(TACE) is known to induce vascular endothelial growth factor (VEGF) expression. A recent study has shown
that doxorubicin can repress hypoxic induction of VEGF expression in human cancer cells.

Objective: To evaluate the combination effects of doxorubicin and TACE on the change of serum VEGF after
TACE.

Material and Method: Thirty patients with unresectable HCC were assigned into two groups, the experiment
group (n = 15) received TACE with doxorubicin (25-50 mg) plus mitomycin C (5-10 mg), and the control
group (n = 15) received TACE with mitomycin C (5-10 mg). Serum VEGF before and after TACE (24 hour) was
measured by quantitative sandwich enzyme-linked immunosorbent assay.

Results: Baseline serum VEGF was correlated with the size of tumor (r2 = 0.85; p = 0.03). In addition, serum
VEGF was significantly elevated after TACE (p = 0.014). However, the change of serum VEGF after TACE is
not statistically different in both groups (p = 0.72). At 2-years, the overall survival was 38% and 40% in the
experiment and control group, respectively (p = 0.48).

Conclusion: The present study suggests that doxorubicin improves neither the level of serum VEGF nor the
survival in HCC patients treated with TACE.

Keywords: Doxorubicin, hepatocellular carcinoma, mitomycin C, transcatheter arterial chemoembolization,
vascular endothelial growth factor

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