ABSTRACT
The hepatic artery-embolizing effect of degradable starch microspheres (DSM) was assessed by dynamic CT scanning soon after embolization in patients with malignant hepatic tumors. Using the Seldinger method, DSM with a mixture of contrast medium, MMC, ADM or Epi-ADM was manually injected. The subjects were 32 patients with metastatic carcinoma of the liver (62 treatments) and 15 patients with hepatocellular carcinoma(19 treatments) (47 patients received 81 treatments in all). Dynamic CT scanning was performed within 2 weeks of each embolization procedure, and the percent reduction in the area visualized (necrotic effect) was calculated to assess the efficacy of embolization. The necrotic effect of embolization was classified as CR, PR, NC, and PD after 9, 41, 10, and 2 treatments, respectively, in the patients with metastatic carcinoma of the liver and after 4, 6, 6, and 3 treatments, respectively, in the patients with hepatocellular carcinoma. Although there was no patient in whom the tumor showed 50% or more reduction, the contrast enhanced area showed 50% or more decrease in 60 out of 81 treatments. Therefore, blocking of blood flow seemed to contribute more to the response than enhancement of the efficacy of the anticancer agents. Adverse reactions were all transient and controllable. Based on our results, intra-arterial chemotherapy plus DSM embolization seems to be useful for treating malignant hepatic tumors.
