[Tumor selective drug delivery with lipid contrast medium (smancs/lipiodol): sustained antitumor effect, enhanced diagnostic value and quantification of dosage regimen].
A new method for the treatment of solid tumor, in particular, primary and metastatic liver cancer using a hydrophobic-polymer conjugated macromolecular anticancer agent, smancs is described. Smancs was dissolving in a lipid contrast medium, Lipiodol, as an injection into the feeding artery. The marked antitumor effect was observed in both experimental animals and human trials. In the patients with hepatocellular carcinoma, both reductions in tumor size and alpha-feto-protein were observed in 91% of the patients. The survival period of the treated patient with highly advanced stage and inoperable cases was comparable to or better than that of resected cases. No major side effect such as bone marrow suppression or liver toxicity was observed due to selective drug delivery to the tumor. About half of the patients, however, showed a transitory fever (37-39 degrees C) for 1-3 days. The mechanism for such selective tumor targeting of anticancer agent appears to be due to the difference in the vascularity of tumor and normal tissue. Furthermore, we found that lack of lymphatic clearance system in the tumor made the prolonged and selective retention of such lipophilic drug in the tumor tissue possible. Another advantages of this method are found in radiological approaches. Differential diagnosis of primary or metastatic cancer became possible and dosing regimen can be determined since a presence of the contrast medium is restricted to the tumor area and it parallels to that of the drug being dissolved. Insufficiency in X-ray staining indicates a need for subsequent injection. The selective remaining of Lipiodol in the tumor for long period may help follow-up study as well.
D000818:Animals; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D001345:Autoradiography; D006801:Humans; D007261:Infusions, Intra-Arterial; D007459:Iodized Oil / Q000008:administration & dosage*; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D008299:Maleic Anhydrides; D011137:Polystyrenes; D011817:Rabbits; D014057:Tomography, X-Ray Computed; D009353:Zinostatin / Q000008:administration & dosage* / Q000031:analogs & derivatives
D000903:Antibiotics, Antineoplastic; D008299:Maleic Anhydrides; D011137:Polystyrenes; C035755:poly(maleic acid-styrene)neocarzinostatin; D007459:Iodized Oil; D009353:Zinostatin