[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 +/- 27 ml/min to 40 +/- 36 ml/min by an hepatic arterial infusion of DSM and, a mean occlusion time aS 24 +/- 11 min. Combined infusion with DSM and MMC reduced MMC levels in the peripheral blood at 0.0248 less than p less than 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.