title: [Combination intra-arterial chemotherapy with degradable starch microspheres and mitomycin C against inoperable hepatic metastases].
abstract: Intra-arterial hepatic infusion chemotherapy combined with degradable starch microspheres (DSM) and mitomycin C (MMC) was performed for 9 patients with inoperable hepatic metastases from alimentary tract primary cancer. DSM, 45 +/- 5 micron in average diameter, produces temporary obstruction of arterial blood flow in the arterio-capillary bed and are subsequently degraded by serum amylase with T 1/2 of about 30 min. This intra-arterial treatment was repeated 2.3 times on the average. The average dose of DSM in a single infusion was 721 +/- 194 mg and the average total dose of MMC was 34.4 +/- 22.3 mg. Antitumor effects were evaluated in terms of tumor regression measured by CT scan and sonography. An objective tumor response was shown in 4/9 patients (44.4%): PR, 2/9; MR, 2/9. Elevated serum CEA levels of more than 3.0ng/ml were decreased in 7/8 patients (87.5%). Marked declines in the CEA level of more than 50% were observed in 4/8 patients (50%). Nausea and vomiting as well as abdominal pain were experienced in 8/21 treatments (38.1%) and 5/21 (23.8%), respectively. Furthermore, fever (2/21 : 9.5%), hepatic dysfunction (2/21 : 9.5%), and leukopenia (1/21 : 4.8%) were observed. All these side effects, however, were mild and transient. Thus, these results suggest that combined intra-arterial administration of DSM and MMC favorably enhances the antitumor efficacy of MMC.
authors.affiliation: 1st Dept. of Surgery, School of Medicine, Chiba University.
authors.forename: S
authors.initials: S
authors.lastname: Koike
authors.forename: S
authors.initials: S
authors.lastname: Fujimoto
authors.forename: F
authors.initials: F
authors.lastname: Endoh
authors.forename: M
authors.initials: M
authors.lastname: Guhji
authors.forename: T
authors.initials: T
authors.lastname: Ooi
authors.forename: K
authors.initials: K
authors.lastname: Okui
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000556:secondary; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D016685:Mitomycin; D008937:Mitomycins / Q000008:administration & dosage*; D013213:Starch / Q000008:administration & dosage*; D013274:Stomach Neoplasms / Q000473:pathology
chemical_list: D008937:Mitomycins; D016685:Mitomycin; D013213:Starch