Koike S, Fujimoto S, Endoh F, Guhji M, Ooi T, Okui K
1st Dept. of Surgery, School of Medicine, Chiba University.
Gan To Kagaku Ryoho. 1988 Mar;15(3):431-5.
Intra-arterial hepatic infusion chemotherapy combined with degradable starch microspheres (DSM) and mitomycin C (MMC) was performed for 9 patients with inoperable hepatic metastases from alimentary tract primary cancer. DSM, 45 +/- 5 micron in average diameter, produces temporary obstruction of arterial blood flow in the arterio-capillary bed and are subsequently degraded by serum amylase with T 1/2 of about 30 min. This intra-arterial treatment was repeated 2.3 times on the average. The average dose of DSM in a single infusion was 721 +/- 194 mg and the average total dose of MMC was 34.4 +/- 22.3 mg. Antitumor effects were evaluated in terms of tumor regression measured by CT scan and sonography. An objective tumor response was shown in 4/9 patients (44.4%): PR, 2/9; MR, 2/9. Elevated serum CEA levels of more than 3.0ng/ml were decreased in 7/8 patients (87.5%). Marked declines in the CEA level of more than 50% were observed in 4/8 patients (50%). Nausea and vomiting as well as abdominal pain were experienced in 8/21 treatments (38.1%) and 5/21 (23.8%), respectively. Furthermore, fever (2/21 : 9.5%), hepatic dysfunction (2/21 : 9.5%), and leukopenia (1/21 : 4.8%) were observed. All these side effects, however, were mild and transient. Thus, these results suggest that combined intra-arterial administration of DSM and MMC favorably enhances the antitumor efficacy of MMC.
对9例无法手术切除的消化道原发性癌肝转移患者进行了肝动脉内灌注化疗，联合使用可降解淀粉微球（DSM）和丝裂霉素C（MMC）。DSM平均直径为45±5微米，可暂时阻塞动脉毛细血管床的血流，随后被血清淀粉酶降解，半衰期约为30分钟。这种动脉内治疗平均重复2.3次。单次输注DSM的平均剂量为721±194毫克，MMC的平均总剂量为34.4±22.3毫克。通过CT扫描和超声检查测量肿瘤退缩情况来评估抗肿瘤效果。9例患者中有4例（44.4%）出现客观肿瘤反应：部分缓解（PR），2/9；轻度缓解（MR），2/9。8例患者中有7例（87.5%）血清癌胚抗原（CEA）水平升高超过3.0ng/ml后下降。8例患者中有4例（50%）CEA水平显著下降超过50%。21次治疗中有8次（38.1%）出现恶心和呕吐，5次（23.8%）出现腹痛。此外，还观察到发热（2/21：9.5%）、肝功能障碍（- 2/21：9.5%）和白细胞减少（1/21：4.8%）。然而，所有这些副作用都很轻微且短暂。因此，这些结果表明，联合动脉内给予DSM和MMC可有效提高MMC的抗肿瘤疗效。
