Isolated hepatic perfusion chemotherapy for unresectable malignant hepatic tumors.
Treatment failure with conventional approaches, including systemic and regional chemotherapy, for refractory advanced primary or metastatic hepatic cancers has evoked periodic waves of enthusiasm for isolated hepatic perfusion (IHP) over the past 50 years. With technical refinements of the procedure and the introduction of a novel biochemical regimen combining tumor necrosis factor and melphalan, several hepatobiliary-oncological centers initiated clinical trials of IHP in the 1990s. In parallel, a percutaneous technique of IHP has been developed in this era as a minimally invasive, simple form of IHP, and phase I and II studies have been done in some specialized centers. This study attempts to review past and current techniques of IHP, and to outline their possible role in the treatment of unresectable hepatic tumors, with special reference to hepatocellular carcinoma and colorectal hepatic metastases.
Ku
Yonson
Y
Department of Gastroenterological Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. yonson@med.kobe-u.ac.jp
Tominaga
Masahiro
M
Iwasaki
Takeshi
T
Fukumoto
Takumi
T
Kuroda
Yoshikazu
Y
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods; D002986:Clinical Trials as Topic; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology
D000970:Antineoplastic Agents