title: Transarterial chemoembolization with degradable starch microspheres, irinotecan, and mitomycin-C in patients with liver metastases.
abstract: Degradable starch microspheres (DSMs) provide transient occlusion of small arteries and are thought to improve the therapeutic effect of anticancer drugs. Irinotecan (CPT-11) is one of the most effective anticancer agents. We herein report cases with liver metastases treated with transarterial chemoembolization with DSM, CPT-11, and mitomycin-C (DSM-CPT therapy). Five patients underwent DSM-CPT therapy for liver metastases that originated from colorectal cancer for four and gastric cancer for one. They all lack indication for surgery. They were all male with an age range of 42-78 years (mean, 55.2 years). Three of them had pretreatment histories with 5-fluorouracil or related agents, and four of them had combined systemic or local chemotherapy at the period. Required doses for stasis of whole blood flow of hepatic artery of DSMs were used with CPT-11 and mitomycin-C. After one to six injections, four patients had a partial response and the disease progressed in one patient with gastric cancer origin. Two of the partial response patients underwent surgery after 2 months of the partial response period. Carcinoembryonic antigen and CA19-9 levels in partial response patients decreased to 16.1% and 19.3% of the level before treatment, respectively. DSM-CPT therapy can be a potential therapy for liver metastases.
authors.affiliation: Department of Surgery and Radiology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsuka-kecho, Toyoake, Aichi 470-1192, Japan. zmorise@aol.com
authors.forename: Zenichi
authors.initials: Z
authors.lastname: Morise
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sugioka
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Kato
authors.forename: Junko
authors.initials: J
authors.lastname: Fujita
authors.forename: Sojun
authors.initials: S
authors.lastname: Hoshimoto
authors.forename: Takazumi
authors.initials: T
authors.lastname: Kato
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery / Q000628:therapy; D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003110:Colonic Neoplasms / Q000473:pathology; D018450:Disease Progression; D006499:Hepatic Artery; D006801:Humans; D007269:Injections, Intra-Arterial; D000077146:Irinotecan; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery / Q000628:therapy; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D012004:Rectal Neoplasms / Q000473:pathology; D012074:Remission Induction; D013213:Starch; D013274:Stomach Neoplasms / Q000473:pathology; D059004:Topoisomerase I Inhibitors
chemical_list: D000903:Antibiotics, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D059004:Topoisomerase I Inhibitors; C083286:degradable starch microspheres; D016685:Mitomycin; D000077146:Irinotecan; D013213:Starch; D002166:Camptothecin