J.Jpn. Surg. Soc.. 92(2): 187-194, 1991

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Original article

TARGETING CANCER CHEMOTHERAPY FOR METASTATIC LIVER CANCER
―EFFECTS OF DSM ON HEPATIC HEMODYNAMICS AND ON CLINICAL OUTCOME―

The effects of intra-arterial infusion of degradable starch microsphere (DSM) on hepatic hemodynamics were studied in 22 patients with metastatic liver cancer and the clinical outcome with mitomycin C (MMC) combined with DSM was reported herein.
Hepatic arterial blood flow, measured with a transit-time ultrasonic blood flow meter, changed 283±27ml/min to 40±36ml/min by an hepatic arterial infusion of DSM and, a mean occlusion time as 24±11min.
Combined infusion with DSM and MMC reduced MMC levels in the peripheral blood at 0.0248＜p＜0.0421, compared with those by an infusion with MMC alone and consequently, these findings proved to result from intrahepatic accumulation Of MMC. RI-angiography using ^99mTc-macroaggregated albumin (^99mTC-MAA) was performed to examine hemodynamic changes in the metastatic liver and, a tumor (T) to non-tumor (N) ratio of ^99mTc-MAA accumulation increased 0.37 to 0.62 by combined use of DSM. Thus, an intra-arterial infusion combined DSM and MCC was performed for 22 patients with unresectable hepatic metastases. Tumor regression was observed in 16 patients (73%). Side effects possibly attributable to DSM was transient nausea and vomiting. These results show that combined use of DSM is effective for intra-arterial chemotherapy against metastatic hepatic cancer.

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