title: [Repeated arterial infusion of zinostatin stimalamer using port for advanced hepatocellular carcinoma].
abstract: Four patients with advanced hepatocellular carcinoma were treated by repeated arterial infusion of zinostatin stimalamer (SMANCS). Every 4 weeks, 4 mg of SMANCS and 4 ml of Lipiodol were administered via the proper hepatic artery using an implantable arterial port. Three patients with advanced liver cirrhosis (Child B or C) could no longer be treated after 2 or 3 courses of SMANCS infusion because of hepatic failure. In the remaining patient also with compensated liver cirrhosis (Child A), a partial response was observed after 5 courses of chemo-infusion, but we discontinued infusion of SMANCS because of hepatic failure. To assess the usefulness of SMANCS for repeated arterial chemo-infusion by the port, we evaluated 103 patients with advanced HCC treated by Lipiodol emulsion mixed with 70 mg of epirubicin (EPI) using a port. An average course was 11 arterial infusions, and the overall response rate was 40%. One-year survival rates were 62% in Child A, 59% in Child B, and 53% in Child C. Compared with Child A and B patients, both elevation of serum total bilirubin levels and decrease of serum albumin levels were observed after 9 months in Child C patients. In conclusion, SMANCS may have more severe hepatic toxicity in comparison with Lipiodol emulsion mixed with EPI.
authors.affiliation: First Dept. of Medicine, Chiba University, School of Medicine.
authors.forename: M
authors.initials: M
authors.lastname: Yoshikawa
authors.forename: M
authors.initials: M
authors.lastname: Ebara
authors.forename: H
authors.initials: H
authors.lastname: Fukuda
authors.forename: N
authors.initials: N
authors.lastname: Sugiura
authors.forename: H
authors.initials: H
authors.lastname: Saisho
mesh_terms: D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000188:drug therapy*; D004334:Drug Administration Schedule; D015251:Epirubicin / Q000008:administration & dosage; D006499:Hepatic Artery; D006801:Humans; D015918:Infusion Pumps, Implantable; D007261:Infusions, Intra-Arterial; D007459:Iodized Oil / Q000008:administration & dosage*; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008299:Maleic Anhydrides / Q000008:administration & dosage*; D008875:Middle Aged; D011137:Polystyrenes / Q000008:administration & dosage*; D009353:Zinostatin / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D008299:Maleic Anhydrides; D011137:Polystyrenes; C035755:poly(maleic acid-styrene)neocarzinostatin; D015251:Epirubicin; D007459:Iodized Oil; D009353:Zinostatin