title: CT-guided intratumoural administration of cisplatin/epinephrine gel for treatment of malignant liver tumours.
abstract: To analyze prospectively the interventional and clinical aspects of computed tomography-guided direct intratumoural injection of a novel chemotherapeutic administration and the parenchymal changes of tumour and necrosis in malignant liver tumours. Eight patients with 17 colorectal liver metastases were treated with a mean of 5.1 injections and nine patients with 13 hepatocellular carcinoma nodules with a mean of 3.1 treatments with computed tomography guided local applications of a novel cisplatin/epinephrine gel. This application provides a higher local and lower systemic drug concentration. Volumes of tumour and necrosis prior and after treatment were measured by computer generated volumetric analysis. Contrast enhanced studies verified pretherapeutic viable tumour volumes with a value of 77.4 ml in the metastases and 29.2 ml in the hepatocellular carcinoma nodules. Intratumoural drug application resulted in a significant increase of necrosis and a decrease in viable tumour volume to be 68.3 ml in metastases and 14.5 ml in hepatocellular carcinoma. Local therapy control rate for the follow up to 6 months was 38 and 71% for the group of metastases and hepatocellular carcinoma, respectively. Direct intratumoural injection of cisplatin/epinephrine injectable gel is a feasible and good tolerated method and results in the development of a statistically significant increase in necrosis in malignant liver tumours. For hepatocellular carcinoma a higher local therapy control rate compared to colorectal metastases can be reported.
authors.affiliation: Department of Diagnostic and Interventional Radiology, JW Goethe University of Frankfurt, Theodor-Stern-Kai 7, 63590 Frankfurt, Germany. t.vogl@em.uni-frankfurt.de
authors.forename: T J
authors.initials: TJ
authors.lastname: Vogl
authors.forename: K
authors.initials: K
authors.lastname: Engelmann
authors.forename: M G
authors.initials: MG
authors.lastname: Mack
authors.forename: R
authors.initials: R
authors.lastname: Straub
authors.forename: S
authors.initials: S
authors.lastname: Zangos
authors.forename: K
authors.initials: K
authors.lastname: Eichler
authors.forename: K
authors.initials: K
authors.lastname: Hochmuth
authors.forename: E
authors.initials: E
authors.lastname: Orenberg
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality; D002945:Cisplatin / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D005782:Gels; D006801:Humans; D015552:Injections, Intralesional; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D015996:Survival Rate; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
chemical_list: D000970:Antineoplastic Agents; D005782:Gels; D014662:Vasoconstrictor Agents; D002945:Cisplatin; D004837:Epinephrine