[Evaluation of liver metastasis of colorectal cancer following hepatic arterial infusion with degradable starch microspheres and adriamycin, mitomycin C as seen in changes in CEA at early stage of therapy].
OBJECTIVE
Recently, for the treatment of unresectable colorectal cancer with liver metastasis, hepatic artery injection of anticancer drugs suspended in degradable starch microspheres (DSM) is being performed. To predict its effectiveness, we did a retrospective study to see whether or not changes in CEA at early stages of therapy are significant.


METHODS
The subjects were 16 patients with unresectable colorectal cancer with liver metastasis (H3) who had undergone DSM therapy at least three times (mean age 65, male to female ratio of 10:6, 6 cases of synchronous metastasis and 10 cases of metachronous metastasis). Adriamycin (ADM) 30 mg and mitomycin C (MMC) 10 mg were suspended in 600 mg of DSM and injected into the common hepatic artery until embolization of the vessel was recognized (once/3-4 weeks). We examined the changes in CEA level (doubling time or half time) and the time to progression (TTP) of CEA after the third DSM treatment.


RESULTS
Of the 16 patients, 4 (25%) showed rise in CEA, of which 3 died within a year. In the 12 cases with decreased CEA, the half time was 20-526 days (mean of 80 days). When the TTP of CEA was compared for the group with CEA half time less than 80 days (n = 6) to those with more then 80 days (n = 6), the TTP was significantly longer in the group with half time less than 80 days (p = 0.02 logrank test).


CONCLUSIONS
To evaluate the effectiveness of DSM therapy, it is important to examine the changes in CEA at the early stages of treatment.
Takeuchi
Ikuya
I
Dept. of Surgery, Saitama Medical Center, Saitama Medical School.
Ishida
Hideyuki
H
Hashimoto
Daijo
D
Mastumoto
Yoshirou
Y
Miura
Tsuyoshi
T
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D015179:Colorectal Neoplasms / Q000473:pathology*; D004317:Doxorubicin / Q000008:administration & dosage; D005069:Evaluation Studies as Topic; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D013213:Starch / Q000008:administration & dosage
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; C083286:degradable starch microspheres; D016685:Mitomycin; D004317:Doxorubicin; D013213:Starch