Hirai K, Yamashita K, Aoki Y, Fujimoto T, Tanaka M, Sakai T, Majima Y, Noguchi H, Miyazone K, Kubo Y
Second Dept. of Medicine, Kurume University School of Medicine.
Gan To Kagaku Ryoho. 1988 Aug;15(8 Pt 2):2653-8.
Transcatheter arterial embolization (TAE) with degradable starch microspheres (DSM) was carried out for fourteen cases with hepatic malignancies including twelve cases with hepatocellular carcinoma (HCC), one case with cholangiocarcinoma and one with metastatic liver cancer. DSM combined with anticancer agents were administered through a catheter introduced by Seldinger's method, in ten cases and through subcutaneously implanted drug delivery system (Port-A-Cath) in four cases. The dose of DSM was 900 mg/body and adriamycin 30-40 mg/m2 through the catheter or 12-14 mg/m2 through Port-A-Cath was used for HCC and cholangiocarcinoma. A same dose of DSM and mitomycin C 15 mg/m2 was administered for metastatic liver cancer through the catheter immediately after angiography. Results were as follows: 1) Partial response (PR) was obtained in six cases (50%) with HCC, and there were two other cases with minor response (MR). PR in cholangiocarcinoma and CR in metastatic liver cancer were obtained. 2) There were no adverse effects in four cases with Port-A-Cath. 3) The concentration of adriamycin in the peripheral venous blood was lower than that of one shot therapy, and decreased rapidly within an hour. These results suggested that good therapeutic effects can be obtained by TAE with DSM combined with anticancer agents for hepatic malignancies.
对14例肝脏恶性肿瘤患者进行了可降解淀粉微球(DSM)经导管动脉栓塞术(TAE),其中包括12例肝细胞癌(HCC)、1例胆管癌和1例转移性肝癌。10例患者通过Seldinger法置入的导管给予DSM联合抗癌药物,4例通过皮下植入式给药系统(Port - A - Cath)给药。对于HCC和胆管癌,通过导管给药时DSM剂量为900mg/体,阿霉素剂量为30 - 40mg/m²;通过Port - A - Cath给药时阿霉素剂量为12 - 14mg/m²。对于转移性肝癌,在血管造影后立即通过导管给予相同剂量的DSM和15mg/m²丝裂霉素C。结果如下:1)12例HCC患者中有6例(50%)获得部分缓解(PR),另有2例轻度缓解(MR)。胆管癌获得PR,转移性肝癌获得完全缓解(CR)。2)4例使用Port - A - Cath的患者未出现不良反应。3)外周静脉血中阿霉素浓度低于单次注射治疗,且在1小时内迅速下降。这些结果表明,DSM联合抗癌药物经导管动脉栓塞术对肝脏恶性肿瘤可取得良好的治疗效果。