title: Ultraselective transcatheter infusion of epirubicin in water-in-oil-in-water emulsion for small hepatocellular carcinoma.
abstract: OBJECTIVE
  We have previously reported the clinical efficacy of water-in-oil-in-water (W/O/W) emulsions, particularly for non-selective transcatheter arterial infusion (TAI) therapy. W/O/W emulsions limit damage to normal hepatic parenchyma, because of their minimal embolic effect on peripheral arteries and slow release of anticancer agent. The purpose of this study was to evaluate the safety and effectiveness of ultraselective TAI (UTI) of a W/O/W emulsion for hepatocellular carcinoma (HCC).
  
  
  METHODS
  11 patients with Stage I-III small HCCs (<5 cm) underwent UTI with a W/O/W emulsion at our institute. Response was assessed using the Response Evaluation Criteria in Solid Tumors. Disease-free survival time was estimated using the Kaplan-Meier method.
  
  
  RESULTS
  All 10 patients, excluding a patient who underwent a hepatectomy after UTI, achieved complete response. The 6, 12 and 30 month cumulative disease-free survival rates for the 10 patients were 100%, 90% and 60%, respectively. The patient who underwent hepatectomy after UTI developed complete necrosis of the HCC and peritumoral non-tumorous liver parenchyma.
  
  
  CONCLUSIONS
  UTI therapy using a W/O/W emulsion for patients with small HCCs results in a good local response.
authors.affiliation: Department of Radiology, Miyakonojo Medical Association Hospital, Miyakonojo, Japan. iku-i@sky.plala.or.jp
authors.forename: I
authors.initials: I
authors.lastname: Ikushima
authors.forename: S
authors.initials: S
authors.lastname: Higashi
authors.forename: A
authors.initials: A
authors.lastname: Ishii
authors.forename: K
authors.initials: K
authors.lastname: Seguchi
authors.forename: Y
authors.initials: Y
authors.lastname: Iryo
authors.forename: Y
authors.initials: Y
authors.lastname: Yamashita
mesh_terms: D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular; D002406:Catheterization, Peripheral; D003692:Delayed-Action Preparations / Q000008:administration & dosage* / Q000737:chemistry; D018572:Disease-Free Survival; D004655:Emulsions / Q000737:chemistry; D015251:Epirubicin / Q000008:administration & dosage* / Q000737:chemistry; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms; D008297:Male; D009821:Oils / Q000737:chemistry; D016896:Treatment Outcome; D014867:Water / Q000737:chemistry
chemical_list: D000903:Antibiotics, Antineoplastic; D003692:Delayed-Action Preparations; D004655:Emulsions; D009821:Oils; D014867:Water; D015251:Epirubicin