[Chemoembolization with degradable starch microspheres in malignant hepatic tumors].

A new method of chemoembolization with degradable starch microspheres (DSM) was used for patients with malignant hepatic tumors. DSM, 40-45 micron in diameter, which are degraded by serum amylase, temporarily obstruct arterial blood flow at the arteriolar capillary bed. Experimental studies have demonstrated that such occlusion enhances the regional uptake and reduces systemic exposure to simultaneously administered arterial anticancer drugs. Transcatheter chemoembolization with DSM was performed in 14 cases of hepatocellular carcinoma and 8 cases of metastatic liver cancer. Adriamycin or Mitomycin C mixed with DSM was injected into the patients with hepatocellular carcinoma or metastatic liver cancer, respectively, through the proper hepatic artery. The therapeutic effect of this chemoembolization was evaluated by the change in tumor size measured by angiography or computed tomography. In hepatocellular carcinoma, tumor regression of over 50% was observed in 5 of 14 patients. Elevated serum AFP level of more than 200 ng/ml was decreased in all 6 cases. In metastatic liver cancer, tumor regression of over 50% was observed in 4 of 8 cases. Although half of the patients had transient pain within 2 hours, no major side effects such as bone marrow suppression and hepatotoxicity were observed. Our results suggest that chemoembolization with DSM can be effectively used in the treatment of malignant hepatic tumors.