Intraarterial infusion chemotherapy with lipiodol-CDDP suspension for hepatocellular carcinoma.
OBJECTIVE
To quantitatively evaluate the usefulness of lipiodol-CDDP suspension (LCS) chemotherapy in hepatocellular carcinoma (HCC).


METHODS
CDDP (cis-diamminedichloroplatinum) powder was prepared by removing the water and NaCl from aqueous CDDP. Two quantities of prepared CDDP powder, 10 mg and 20 mg, were mixed with 1 ml each of iopamidol 300 mgI/ml (IP300) and lipiodol (LPD) using a high pressure pumping method, thus producing LCS. Thirty-two patients with HCC, who had good renal function [creatinine clearance (Ccr) 50 ml/min or more], received additional intraarterial infusion chemotherapy with LCS or LCS alone.


RESULTS
The most frequently observed CDDP powder sizes were 5.95-10.90 microm (average: 11.59 microm). The LCS obtained demonstrated a suspension of 2-12 microm (average 3.69 microm) immediately after mixing, and no significant changes were observed in LCS particle sizes 3 hr after mixing. Moreover, the sustained release with LCS was observed for up to 3 hr. Meanwhile, the peripheral free platinum concentration between intraarterial infusion chemotherapy with LCS and intraarterial infusion with the aqueous solution of CDDP, with respect to variance residence time (VRT), showed a significant difference, with a p value of 0.0382. The survival rate was 89.84% at 1 year, 73.78% at 2 years, and 68.51% at 3 years. Furthermore, the platinum concentration in the tumor was 25-95 times the concentration in the surrounding liver parenchyma.


CONCLUSIONS
Good clinical results can be expected by applying LCS to HCC.
Yamamoto
K
K
Department of Radiology, Osaka Medical College, 2-7 Daigaku-chou, Takatsuki-City, Osaka 569-0801, Japan.
Shimizu
T
T
Narabayashi
I
I
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D007459:Iodized Oil / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010316:Particle Size; D011208:Powders; D015996:Survival Rate; D013535:Suspensions; D014057:Tomography, X-Ray Computed
D000970:Antineoplastic Agents; D011208:Powders; D013535:Suspensions; D007459:Iodized Oil; D002945:Cisplatin