The role of sandostatin LAR in treating patients with advanced hepatocellular cancer.

Background/aims: The overexpression of somatostatin receptors in the liver of some patients with hepatocellular carcinoma is well documented. The daily administration of octreotide in patients with advanced hepatocellular carcinoma was shown to have a marginal clinical effectiveness. The aim of the study was to estimate if and to what extent the administration of octreotide long-acting formulation (Sandostatin LAR) improves survival and quality of life in patients with advanced unresectable hepatocellular carcinoma.

Methodology: Twenty-eight cirrhotic patients (stages A-B) with advanced hepatocellular carcinoma were enrolled in the study. Octreoscan scintigraphy for detection of STTR was performed in all cases. If it showed intense uptake in the liver, octreotide was administered as follows: Sandostatin 0.5 mg subcutaneous every 8 hours for 6 weeks. At the end of weeks 4-8 Sandostatin LAR 20 mg and at the end of week 12 and every 4 weeks Sandostatin LAR 30 mg intramuscularly. Patients' follow-up was worked out monthly. Thirteen patients unable to receive treatment were used as control group.

Results: Comparison of results between the 2 groups showed a significant difference in the median survival time (31 vs. 16 weeks, p = 0.037) and an improvement of quality of life (60% vs. 23.07%). Also, treated group showed a 72% reduction in the risk of dying during the follow-up period (p = 0.002). No alpha-fetoprotein reduction and decrease of the tumor mass was observed.

Conclusions: In conclusion, the administration of Sandostatin LAR it appears to improve the survival and the quality of life in patients with advanced hepatocellular carcinoma.