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Chemo-Occlusion for the Treatment of Liver Cancer

A New Technique Using Degradable Starch Microspheres

  • Review Article
  • Drug Delivery Systems
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Summary

The use of particulate embolic agents combined with regional chemotherapy in the treatment of hepatocellular carcinoma and metastatic liver cancer has been widely investigated over the past decade. The rationale for the use of such agents is to provide vascular blockade, resulting in a reduced or halted blood flow. This increases the in situ time, tumour exposure and, thus, efficacy of any coadministered cytotoxic drug. Of all the embolic agents and techniques available, degradable starch microspheres (DSMs) are the agents that have been evaluated most extensively. DSMs are non-toxic, are readily degradable and provide temporary vascular occlusion. Phase II and III clinical trials have demonstrated the efficacy of DSM when coadministered with chemotherapeutic drugs (chemo-occlusion), as measured by tumour response. Indeed, compared with drug therapy alone, a significantly greater tumour response is associated with chemo-occlusion, for patients with either hepatocellular carcinoma or metastatic liver cancer.

The use of combination or multimodular therapies have, in recent years, been investigated. The therapeutic benefits associated with chemo-occlusion would suggest that this technique might have a potential application as an adjuvant, or neoadjuvant therapy, for example, in reducing tumour recurrence after surgical resection in hepatocellular carcinoma, or downstaging a tumour prior to surgical resection, respectively. Furthermore, comprehensive management of patients with liver metastases and potential extrahepatic involvement may well be achieved by a combination of DSM chemo-occlusion and systemic chemotherapy. Large, randomised trials are, however, required to access more fully the clinical benefits associated with chemo-occlusion, such as, quality of life, time to tumour progression and survival.

Regionally occlusive techniques administered with cytotoxic agents have also shown potential in the treatment of alternative cancers, for example, breast and pancreatic carcinomas. However, these therapies require further evaluation.

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References

  • Aigner KR, Gailhofer S. Celiac axis infusion for locally metastasized pancreatic cancer using Spherex/mitoxantron microembolisation and mitomycin chemofiltration. Abstract A2. Regional Cancer Treatment 4: 3, 1991

    Google Scholar 

  • Aigner KR, Gailhofer S. Regional chemotherapy for nonresectable, locally metastasized pancreatic cancer — four studies including 164 cases. Abstract A2. Regional Cancer Treatment (Suppl. 1): 2, 1993

    Google Scholar 

  • Aigner KR, Gailhofer S, Muller H. Regional chemotherapy of advanced pancreatic cancer with mitoxantron-spherex and mitomycin C-chemofiltration. In Klapdor (Ed.) Tumor associated antigens, oncogenes, receptors, cytokines in tumor diagnosis and therapy at the beginning of the nineties. W. zuckschwerdt Verlag Munchen, Germany, pp. 692–696, 1992

    Google Scholar 

  • Aigner KR, Muller H, Chatzissavidis J. Subclavian artery infusion for locally recurrent breast cancer: a review on 144 patients. Abstract A3. Regional Cancer Treatment (Suppl. 1): 3, 1993

    Google Scholar 

  • Akuta K, Abe M, Konda M, Yoshikawa T, Tanaka Y, et al. Combined effects of hepatic arterial embolization using degradable starch microspheres (DSM) in hyperthermia of liver cancer. International Journal of Hyperthermia 7: 231–242, 1991

    Article  PubMed  CAS  Google Scholar 

  • Anderson J, Angerson W, Willmott N, Kerr D, McArdle C, et al. Regional delivery of microspheres to liver metastases: the effects of particle size and concentration on hepatic distribution. British Journal of Cancer 64: 1031–1034, 1991

    Article  PubMed  CAS  Google Scholar 

  • Andersson M, Aronson KF, Balch C, Domellof L, Eksborg S, et al. Pharmacokinetics of intra-arterial mitomycin C with or without degradable starch microspheres (DSM) in the treatment of non-resectable liver cancer. Acta Oncologica 28: 219–222, 1989

    Article  PubMed  CAS  Google Scholar 

  • Aronsen K, Hellekant C, Holmberg J, Rothman U, Teder H. Controlled blocking of hepatic artery flow with enzymatically degradable microspheres combined with oncolytic drugs. European Surgical Research 11: 99–106, 1979

    Article  PubMed  CAS  Google Scholar 

  • Balkwill F. Cytokines in cancer therapy. Scrip Magazine, March, pp. 17–19, 1992

    Google Scholar 

  • Bengmark S, Peterson-Dhal E, Fredlund PE. Hepatic detarterialization and infusion treatment of liver tumors. In Peterson (Ed.) Tumor blood circulation: angiogenesis, vascular morphology and blood flow of experimental and human tumors, pp. 203–216, Baton Rouge, CRC Press Inc., 1979

    Google Scholar 

  • Bleiberg H, Pector JC, Frühling J, Parmentier N, Gerard B, et al. Hepatic intra-arterial fotemustine combined with degradable starch microspheres: pharmacokinetics in a phase I–III trial. Regional Cancer Treatment 4: 237–243, 1992

    Google Scholar 

  • Borner M, Castiglione M, Treller J, Baer H, Soucek M, et al. Considerable side effects of chemoembolization for colorectal carcinoma metastatic to the liver. Annals of Oncology 3: 113–115, 1992

    PubMed  CAS  Google Scholar 

  • Bowman WC, Rand MJ. Textbook of Pharmacology (2nd ed). Blackwell Scientific Publications, England, p 262, 1988

    Google Scholar 

  • Chang A, Schneider P, Sugarbaker PD, Sugarbaker PH, Simpson C, et al. A prospective randomised trial of regional versus systemic continuous 5-fluorodeoxyuride chemotherapy in the treatment of colorectal liver metastases. Annals of Surgery 206: 685–693, 1987

    Article  PubMed  CAS  Google Scholar 

  • Civalleri D, Esposito M, Fulco R, Vannozzi M, Balletto N, et al. Liver and tumour uptake and plasma pharmacokinetics of arterial cisplatin administration with and without starch microspheres in patients with liver metastases. Cancer 68: 988–994, 1991

    Article  PubMed  CAS  Google Scholar 

  • Civalleri D, Pector J-C, Hakansson L, Arnaud J-P, Duez N, et al. Treatment of unresectable liver metastases from colorectal cancer by chemo-occlusion using degradable starch microspheres. British Journal of Surgery, in press, 1994

    Google Scholar 

  • Civalleri D, Rollandi G, Simoni G, Mallarini G, Repetto M, et al. Redistribution of arterial blood flow in metastases-bearing livers after infusion of degradable starch microspheres. Acta Chirurgica Scandinavica 151: 613–617, 1985

    PubMed  CAS  Google Scholar 

  • Civalleri D, Scopinaro G, Balletto N, Claudiani F, DeCian F, et al. Changes in the vascularity of liver tumours after hepatic arterial embolization with degradable starch microspheres. British Journal of Surgery 76: 699–703, 1989

    Article  PubMed  CAS  Google Scholar 

  • Czejka MJ, Schaller J, Juger W, Fogl U, Weiss Ch, et al. Improvement of the local bioavailability of 5-fluorouracil. I: Application of biodegradable microspheres and clinical pharmacokinetics. International Journal of Experimental and Clinical Chemistry 4: 161–165, 1991

    Google Scholar 

  • Dakhil S, Ensminger W, Cho K, Niederhuber J, Doan K, et al. Improved regional selectivity of hepatic arterial BCNU with degradable starch microspheres. Cancer 50: 631–635, 1982

    Article  PubMed  CAS  Google Scholar 

  • Daniels J, Kerlan R, Dodds L, McLaughlin P, Rerge J, et al. Peripheral hepatic arterial embolization with crosslinked collagen fibres. Investigative Radiology 22: 126–131, 1987

    Article  PubMed  CAS  Google Scholar 

  • Dawbarn RH. The starvation operation for malignancy in the external carotid area — failures and successes. Journal of the American Medical Association 43: 792–795, 1904

    Article  Google Scholar 

  • de Dycker RP. Preoperative arterial induction chemotherapy in breast cancer. Abstract D4, Regional Cancer Treatment (Suppl. 1): 16, 1993

    Google Scholar 

  • de Dycker RP, Timmermann J. Combined intra-arterial hepatic infusion of degradable starch microspheres and cytostatics in the treatment of breast cancer liver metastases. Regional Cancer Treatment 3: 302–304, 1991

    Google Scholar 

  • Donatini B, Rougier P. Anatomical basis for pancreatic locoregional chemotherapy. Regional Cancer Treatment 4: 272–276, 1992

    Google Scholar 

  • Edman P, Sjoholm I. Chemoemobolization and passive targeting with degradable starch microspheres. In Donbrow (Ed.) Microspheres and nanoparticles in medicine and pharmacy, pp. 265–280, CRC Press, USA, 1992

    Google Scholar 

  • Eggermont AM, van Ooijen B, Wiggers T. Locoregional immunotherapy for nonresectable malignant hepatic disease. Regional Cancer Treatment 4: 227–231, 1992

    Google Scholar 

  • Eibl-Eibesfeldt B, Pfeifer KJ, Wilker D, Izbicki J, Waldner H. Prolonged ischemia in liver malignancies, using DSM (degradable starch microspheres). In Hottenrott & Qvick (Eds) Spherex in locoregional cancer treatment. Excerpts from a workshop, Nov 1988, Tegernsee, Bergstens Grafiska AB, Helsingborg, Sweden, pp. 55–70, 1990

    Google Scholar 

  • Endoh F. Intra-arterial infusion chemotherapy with mitomycin C containing microspheres. Gan to Kagaku Ryoho 10: 1940–1941, 1985

    Google Scholar 

  • Ensminger W. Intraarterial therapy. In Perry (Ed.) The Chemotherapy Source Book, Chapter 16, pp. 256–271, Williams and Wilkins, USA, 1992

    Google Scholar 

  • Ensminger WD, Gyves JW, Stetson P, Walker-Andrew S. Phase I study of hepatic arterial degradable starch microspheres and mitomycin. Cancer Research 45: 4464–4467, 1985

    PubMed  CAS  Google Scholar 

  • Epenetos AA, Courtenay-Luck N, Dhokia B, Snook D, Hooker G, et al. Antibody-guided irradiation of hepatic metastases using intrahepatically administered radiolabelled anti-CEA antibodies with simultaneous and reversible hepatic blood flow stasis using biodegradable starch microspheres. Nuclear Medicine Communications 8: 1047–58, 1987

    Article  PubMed  CAS  Google Scholar 

  • Falkson G, Cnaan A, Simson IW, Dayal Y, Falkson H, et al. A randomised phase II study of acivicin and 4-deoxydoxorubicin in patients with heptocellular carcinoma in an eastern co-operative oncology group study. American Journal of Clinical Oncology — Cancer Clinical Trials 13: 510–515, 1990

    CAS  Google Scholar 

  • Falkson G, Maclntyre JM, Moertel CG, Johnson LA, Scherman RC. Primary liver cancer. An eastern co-operative oncology group trial. Cancer 54: 970–977, 1984

    Article  PubMed  CAS  Google Scholar 

  • Forsberg JO. Transient blood flow reduction induced by intra-arterial injection of degradable starch microspheres. Acta Chirurgica Scandinavica 144: 275–281, 1978

    PubMed  CAS  Google Scholar 

  • Gailhofer S, Aigner KR. Celiac axis/superior mesenteric artery DSM (Spherex®) microembolisation with MMC and CDDP and aortic stop-flow infusion (MMC) for locally metastasized nonresectable pancreatic cancer — 49 patients. Abstract G2. Regional Cancer Treatment (Suppl. 1): 24, 1993

    Google Scholar 

  • Gerard A. Pilot study on the regional treatment of colorectal liver metastases by intermittent arterial ischemia with degradable starch microspheres and arterial and portal infusion with mitomycin C plus 5-fluorouracil — a clinical trial led by the Gastrointestinal Tumour Cooperative Group EORTC. Gan to Kagaku Ryoho 15: 2627–32, 1988

    PubMed  CAS  Google Scholar 

  • Goldberg J, Thompson J, Bradham M, Fenner J, McKillop J, et al. Angiotensin II as a potential method of targeting cytotoxic-loaded microspheres in patients with colorectal liver metastases. British Journal of Cancer 64: 114–119, 1991a

    Article  PubMed  CAS  Google Scholar 

  • Goldberg JA, Willmott NS, Anderson JH. The biodegradation of albumin microspheres used to regional chemotherapy in patients with colorectal liver metastases. Nuclear Medicine Communications 12: 57–63, 1991b

    Article  PubMed  CAS  Google Scholar 

  • Gyves J, Ensiminger W, VanHarken D, Niederhuber J, Stetson P, et al. Improved regional selectivity of hepatic arterial mitomycin by starch microspheres. Clinical Pharmacology and Therapeutics 34: 259–265, 1983

    Article  PubMed  CAS  Google Scholar 

  • Hakansson L, Starkhammer H. Degradable starch microspheres in intra-arterial tumor treatment: an overview. In Jakenz & Rainer (Eds) Progress in Regional Cancer Therapy, 89–97, Springer-Verlag, Berlin, 1990

    Chapter  Google Scholar 

  • Hohn DC, Stagg RJ, Friedman MA, Hannigan JF, Rayner A, et al. A randomised trial of continuous intravenous versus hepatic intra arterial fluoxuridine in patients with colorectal cancer to the liver. The Northern California Oncology Group Trial. Journal of Clinical Oncology 7: 1646–1654, 1989

    PubMed  CAS  Google Scholar 

  • Hu E, Howell SB. Pharmacokinetics of intra-arterial mitomycin C in humans. Cancer Research 43: 4474–4477, 1983

    PubMed  CAS  Google Scholar 

  • Ikeda K, Saitih S, Tsubota A, Arase Y, Chayama K, et al. Risk factors for tumor recurrence and prognosis after curative resection of hepatocellular carcinoma. Cancer 71: 19–25, 1993

    Article  PubMed  CAS  Google Scholar 

  • Kamphorst E, Schmoll E, Kynast B, Schmoll HJ. Hepatic arterial treatment of nonresectable metastatic liver cancer (CRC) with 5-FU modulated by folinic acid, alpha interferon and degradable starch microspheres (Spherex). Abstract. Journal of Cancer Research and Clinical Oncology 118 (Suppl.): R145, 1992

    Google Scholar 

  • Kemeny N. Review of regional therapy of liver metastases in colorectal cancer. Seminars in Oncology 19: 155–162, 1992

    PubMed  CAS  Google Scholar 

  • Kemeny N, Civalleri D, Edmans P, Nilsson B, Gunnarsson K, et al. (eds) Liver cancer: a review of current treatment options. In An update of regional treatment of liver cancer. The role of vascular occlusion. Wells Medical, England, pp. 1–16, 1992

  • Kemeny N, Conti J, Sigurdson E, Cohen A, Seiter K, et al. A pilot study of hepatic artery fluoxuridine combined with systemic 5-fluorouracil and leucovorin. A potential adjuvant program after resection of colorectal hepatic metastases. Cancer 71: 1964–1971, 1993

    Article  PubMed  CAS  Google Scholar 

  • Kemeny N, Daly J, Reichman B, Geller N, Botet J, et al. Intrahepatic or systemic infusion of fluorodeoxyuridine in patients with liver metastases for colorectal cancer. Annals of Internal Medicine 107: 459–465, 1987

    PubMed  CAS  Google Scholar 

  • Kerr D, Kaye S. Chemoembolism in cancer chemotherapy. Clinical Review of Therapeutic Carrier Systems 8: 19–37, 1991

    CAS  Google Scholar 

  • Koike S. Changes of hepatic haemodynamics by intrahepatic arterial infusion of DSM. Japanese Journal of Cancer Chemotherapy 18: 2818–2821; 1989a

    Google Scholar 

  • Koike S, Fulimoto S, Guhji M, Shrestha BD, Kokubumn M, et al. Effect of degradable starch microspheres (DSM) on hepatic hemodynamics. Gan to Kagaku Ryoho 16: 2818–2821, 1989b

    PubMed  CAS  Google Scholar 

  • Krag D, Theon A, Schneider P, Goodnight J. Intralesional cisdiamminedichloroplatinum and purified collagen treatment of human metastatic malignancies: a feasibility study. Journal of Surgical Oncology 43: 83–87, 1990

    Article  PubMed  CAS  Google Scholar 

  • Kulzer R, Schoppe WD, Porschen R, Planker M, Wirzt F, et al. Arterial chemotherapy of liver metastases using implantable infusion systems. Abstract. Journal of Cancer Research and Clinical Oncology 111: S97,1986

    Article  Google Scholar 

  • Kuroda C, Sakurai M, Monden M, Marukawa T, Hosoki T, et al. Limitation of transcatheter arterial chemoembolization using iodized oil for small hepatocellular carcinoma. A study in resected cases. Cancer 67: 81–86, 1991

    Article  PubMed  CAS  Google Scholar 

  • Lai C-L, Lau J, Wu P-C, Ngan H, Chung H-T, et al. Recombinant interferon-a in inoperable hepatocellular carcinoma: a randomised controlled trial. Hepatology 17: 389–394, 1993

    Article  PubMed  CAS  Google Scholar 

  • Lai E, Choi T, Cheng G, Mok F, Fan ST, et al. Doxorubicin for unresectable hepatocellular carcinoma. A prospective study on the addition of verapamil. Cancer 66: 1685–1687, 1990

    Article  PubMed  CAS  Google Scholar 

  • Lange OF, Jamitzky T. Intraarterial chemotherapy for locally recurrent breast cancer. Abstract LI. Regional Cancer Treatment (Suppl. 1): 34, 1993

    Google Scholar 

  • Lindberg B, Lote K, Teder H. Biodegradable starch microspheres. A new medical tool. In Davis et al. (Eds) Microspheres and drug therapy, pp. 153–138, Pharmaceutical, Immunological and Medical Aspects, Amsterdam, Elsevier, 1984

    Google Scholar 

  • Lorenz M, Herrmann G, Kirkowa-Reimann M, Rauber K, Herrhausen T, et al. Temporary chemoembolization of colorectal metastases with degradable starch microspheres. European Journal of Surgical Oncology 15: 453–462, 1989

    PubMed  CAS  Google Scholar 

  • Lorenz M, Hottenrott C, Baum RP, Liermann D, Encke A. Chemoembolization of hepatic tumors with degradable starch microspheres (DSM). In Hottenrott & Qvick (Eds) Spherex in locoregional cancer treatment. Excerpts from a workshop: Nov 1988; Tegernsee; 12–26, 1990

    Google Scholar 

  • Martin JK, O’Connell MJ, Wieand HS, Fitzgibbon RJ, Mailliard JA, et al. Intra-arterial fluoxuridine versus systemic fluorouracil for hepatic metastases from colorectal cancer: a randomised trial. Archives of Surgery 125: 1022–1027, 1990

    Article  PubMed  Google Scholar 

  • Masutani S, Sasaki Y, Imaoka S, Ohashi I, Ishikawa O, et al. The assessment of preoperative transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC) — the comparison between ‘whole-liver’ TAE and ‘lobar or segmental’ TAE. Nippon Shokakibyo Gakkai Zasshi 88: 2757–2762, 1991

    PubMed  CAS  Google Scholar 

  • Mavligit G, Zukiwski AA, Charnsangavej C, Humberto Carrasco C, Wallace S, et al. Hepatic artery infusion of recombinant human necrosis factor in patients with liver metastases. Cancer 69: 557–561, 1992

    Article  PubMed  CAS  Google Scholar 

  • Michel P, Nizer J, Lardinois J, Bastin F, Cleve T. Regional chemotherapy and breast conservation. Abstract M4. Regional Cancer Treatment (Suppl. 1): 39, M4, 1993

    Google Scholar 

  • Moosa A, Schinpff S, Robinson M. (Eds) Comprehensive Textbook of Oncology. Williams and Wilkins Co., USA, pp. 948–957 & 1625’1637, 1991

    Google Scholar 

  • Morino M., Miglietta C, Grosso M, Giuli M, Bismuth H. Preoperative chemoembolisation for hepatocellular carcinoma. Journal of Surgical Oncology (Suppl. 3): 91–93, 1993

    Google Scholar 

  • Nilsson LA. Therapeutic hepatic artery ligation in patients with secondary liver tumors. Review of Surgery 23: 374–376, 1966

    PubMed  CAS  Google Scholar 

  • Nott DM, Yates J, Grime SJ, Maltby M, Cooke TG, et al. The effect of portal venous flow on the washout of a regionally injected marker substance 99mTc-methylene diphosphonate after hepatic arterial blockade with degradable starch microspheres. European Journal of Surgical Oncology 1: 347–352, 1992

    Google Scholar 

  • Ohishi H, Yoshimura H, Uchida H, Sakaguchi H, Yoshioka T, et al. Tanscatheter arterial embolization using iodized oil (Lipiodol) mixed with an anticancer drug for the treatment of hepatocellular carcinoma. Cancer Chemotherapy and Pharmacology 23: S33–S36, 1989

    Article  PubMed  Google Scholar 

  • Ohya K, Kawai T, Kametani S, Soma G. A case of hepatoma, resulting in complete response with combination treatment of endogenous-exogenous TNF (EET) therapy, Lipiodol chemoembolization and cisplatin continuous arterial infusion. Biotherapy 5: 1499–1502, 1991

    Google Scholar 

  • Pape H, Geismar D, Schmid G. Capillary density in preirradiated breast cancer to predict chemotherapeutic response. Abstract P3. Regional Cancer Treatment (Suppl. 1): 40, 1993

    Google Scholar 

  • Parker G, Regelson W. Treatment of primary and secondary liver cancers with intra-arterial chemotherapy mixed with biodegradable starch microspheres. Abstract. Proceedings of American Society of Clinical Oncology 4: 90, 1985

    Google Scholar 

  • Pelletier G, Roche A, Ink O, Anciaux M, Derhy S, et al. Arandomised trial of hepatic arterial chemoembolisation in patients with unresectable hepatocellular carcinoma. Journal of Hepatology 11: 181–184, 1990

    Article  PubMed  CAS  Google Scholar 

  • Persson BG, Jeppsson B, Andersson L, Strand S-E, Ekelund L, et al. The prevention of arterial collaterals after repeated temporary blockade of the hepatic artery in pigs. World Journal of Surgery 11: 672–677, 1987

    Article  PubMed  CAS  Google Scholar 

  • Persson B, Jeppsson B, Ekberg H, Tranberg KG, Lundstedt C, et al. Repeated dearterialization of hepatic tumors with an implantable occluder. Cancer 66: 1139–1146, 1990

    Article  PubMed  CAS  Google Scholar 

  • Pfeifle CE, Howell SB, Bookstein JJ. Pilot study of intra-arterial fluoxuridine, mitomycin and doxorubicin in combination with degradable starch microspheres to treat primary and metastatic tumors of the liver. Cancer Drug Delivery 2: 305–311, 1985

    Article  PubMed  CAS  Google Scholar 

  • Ravoet C, Bleiberg H, Gerard B. Non-surgical treatment of hepatocarcinoma. Journal of Surgical Oncology (Suppl. 3): 104–111, 1993

    Google Scholar 

  • Rougier PH, Ducreux M, Elias D, Commandella MG, Deraco M, et al. Indications of intra-arterial hepatic chemotherapy (IAHC) for liver metastatic (LM) from colorectal cancer (CRC). Abstract R4, Regional Cancer Treatment (Suppl. 1): 42–43, 1993

    Google Scholar 

  • Rougier PH, Laplanche A, Huguier M, Hay JM, Ollivier JM, et al. Hepatic arterial infusion of fluoxuridine in patients with liver metastases from colorectal carcinoma: long-term results of a prospective randomized trial. Journal of Clinical Oncology 10: 1112–1118, 1992.

    PubMed  CAS  Google Scholar 

  • Sakurai M, Okamura J, Kuroda C. Transcatheter chemoembolization effective for treating hepatocellular carcinoma. A histopathologic study. Cancer 54: 387–392, 1984

    Article  PubMed  CAS  Google Scholar 

  • Scholz A, Langer M, Langer R, Felix R, Neuhau P. Intra-arterial chemoembolization of nonresectable hepatocellular carcinomas. Fortschr. Rontgenstr 154: 258–261, 1991

    CAS  Google Scholar 

  • Schuller J, Czejka M, Weiss C, Wirth M, Micksche M, et al. In vitro interaction and pharmacokinetics (PK) of intrahepatic (IH) 5FU-interferon a2 (IFN) combined with starch microspheres. Presented at the 4th International Congress on Anti-cancer chemotherapy, Paris, Abstract 183, 1993.

  • Sigurdson ER, Ridge JA, Daly JM. Intra-arterial infusion of doxorubicin with degradable starch microspheres. Archives of Surgery 121: 1277–1281, 1986

    Article  PubMed  CAS  Google Scholar 

  • Smerieri F, Cantore. M, Fiorentini G, Aitini E, Cavazzini G, et al. IAC in locally advanced and recurrent breast cancer. Abstract C4. Regional Cancer Treatment (Suppl. 1): 10, 1993

    Google Scholar 

  • Soga K, Nomoto M, Ichida T, Aoyagi Y, Ozaki T, et al. Clinical evaluation of transcatheter arterial embolization and one-shot chemotherapy in hepatocellular carcinoma. Hepato-Gastroenterology 35: 116–120, 1988

    PubMed  CAS  Google Scholar 

  • Starkhammar H, Hakansson L. Effect of starch microspheres on the passage of labelled erythrocytes and low molecular weight marker through the liver. Acta Oncologica 26: 361–365, 1987

    Article  PubMed  CAS  Google Scholar 

  • Starkhammar H, Hakansson L, Morales O, Sjodahl R, Ekberg S, et al. Degradable starch microspheres in cancer treatment: effect on regional blood flow and uptake of cytostatic drugs. In Ishigami (Ed.) Recent Advances in Chemotherapy, pp. 1286–1287, Tokyo Press, Tokyo, 1985

    Google Scholar 

  • Sternlicht M, Danials JR, Sales SF, Danials A. Effect of antimicrobial protection on tolerance to hepatic chemoembolization with a fibrous collagen carrier. Radiology 170: 1067–1071, 1989

    PubMed  CAS  Google Scholar 

  • Sugarbaker PH, Steves MA. A cytoreductive approach to treatment of multiple liver metastases. Journal of Surgical Oncology (Suppl 3): 161–165, 1993.

    Google Scholar 

  • Taguchi T, and the DSM Study Group Japan. Clinical results of chemotherapy combined with degradable starch microspheres. In Hottenrott & Quick (Eds.) Spherex in local-regional cancer treatment. Extracts from a workshop, November 1988, Tegernsee, Bergstens Grafiska AB, Helsingborg, Sweden, pp. 27–28, 1990

    Google Scholar 

  • Taguchi T, Nakamura H. Chemoembolisation therapy for hepatocellular carcinoma in Japan. Journal of Incisional Chemotherapy 2: 124–127, 1992

    Google Scholar 

  • Taguchi T, Ogawa N, Bunke B, Nilsson B, DSM Study Group. The use of degradable starch microspheres (Spherex®) with intra-arterial chemotherapy for the treatment of primary and secondary liver tumors — results of phase III clinical trial. Regional Cancer Treatment 4: 161–165, 1992

    Google Scholar 

  • Takekoshi H. Immunochemo-embolization therapy for hepatocellular carcinoma (HCC). Regional Cancer Treatment 3–4: 88–91, 1992

    Google Scholar 

  • Tanaka Y, Ohtani Y, Tsukui M, Gotoh K, Makuuchi H, et al. Clinical evaluation of operative and nonoperative treatment in hepatocellular carcinoma with main portal vein tumor thrombus. Nippon Geka Gakkai Zasshi 93: 1111–1114, 1992

    PubMed  CAS  Google Scholar 

  • Teder H, Nilsson B, Jonsson K, Hellekant C, Aspegren K, et al. Hepatic arterial administration of doxorubicin (adriamycin) with and without degradable starch microspheres: a pharmacokinetic study in man. In Hansen (Ed.) Anthracyclines and Cancer Therapy, pp. 166–174, Excerpta Medica, Amsterdam, 1983

    Google Scholar 

  • Tennvall GR, Persson U, Håkansson L, Warfving T. The cost-effectiveness of using degradable starch microspheres (DSM) in patients with hepatocellular carcinoma or colorectal hepatic metastases. Regional Cancer Treatment, in press, 1994

    Google Scholar 

  • Thorn AK, Sigurdson ER, Bitar M, Daly JM. Regional hepatic arterial infusion of degradable starch microspheres increases fluorodeoxyuridine (FUDR) tumor uptake. Surgery 105: 383–392, 1989

    Google Scholar 

  • Thom AK, Sigurdson ER, Daly JM. Use of degradable starch microspheres (DSM’s) in patients with hepatic metastases. Abstract. Proceedings of the American Society of Clinical Oncology 6: A311; 1987

    Google Scholar 

  • Thulin L, Tyden G, Nyberg B, Calissendorff B, Hulcrantz R. Reduction of hepatic arterial flow by degradable microspheres in patients with liver tumor. Acta Chirurgica Scandinavica 152: 447–451, 1986

    PubMed  CAS  Google Scholar 

  • Uchida H, Ohnishi H, Matsuo N, Nishimine K, Ohue S, et al. Trans-catheter hepatic segmental arterial embolization using Lipiodol mixed with an anticancer drug and Gelfoam particles for hepatocellular carcinoma. Cardiovascular and Interventional Radiology 13: 140–145, 1990

    Article  PubMed  CAS  Google Scholar 

  • van Beers B, Roche A, Cauquil P, Jamart J, Pariente, et al. Trans-catheter arterial chemotherapy using doxorubicin, iodized oil and gelfoam embolization in hepatocellular carcinoma. Acta Radiologica 30: 415–418, 1989

    Article  PubMed  Google Scholar 

  • van der Schelling GP, Ijzermans JN, Kok TC, Scheringa M, Marquet R, et al. A phase I study of local treatment of liver metastases with recombinant tumor necrosis factor. European Journal of Cancer 28A: 1073–1078, 1992

    Article  PubMed  Google Scholar 

  • van Thiel D, Carr B, Iwatsuki S, Selby R, Fung J, et al. The 11-year Pittsburgh experience with liver transplantation for hepatocellular carcinoma: 1981–1991. Journal of Surgical Oncology (Suppl 3): 78–82, 1993

    Google Scholar 

  • Vernook AR, Stagg RJ, Lewis BJ, Chase JL, Ring EJ, et al. Chemoembolization for hepatocellular carcinoma. Journal of Clinical Oncology 8: 1108–1114, 1990

    Google Scholar 

  • Wadler S. The role of immunotherapy in colorectal cancer. Seminars in Oncology 18: 27–38, 1991

    PubMed  CAS  Google Scholar 

  • Wadler S, Wiernik PH. Clinical update on the role of fluorouracil and recombinant interferon alpha-2a in the treatment of colorectal carcinoma. Seminars in Oncology 17: 16–21, 1990

    PubMed  CAS  Google Scholar 

  • Witte VG, Kremer B, Henne-Bruns D, Jordon A, Bicheler E. Chemoembolisation beim primaren Leberzellkarzinom. Fortschr. Rontgenstr 154: 634–637, 1991

    Article  CAS  Google Scholar 

  • Wollner IS, Walker-Andrews SC, Smith JE, Ensminger WD. Phase II study of hepatic arterial degradable starch microspheres and mitomycin C. Cancer Drug Delivery 3: 279–84, 1986

    Article  PubMed  CAS  Google Scholar 

  • Yamada R, Sato M, Nakatsuka H, Nakamura R, Takashima S. Hepatic artery embolization in 120 patients with unresectable hepatoma. Radiology 148: 397–401, 1983

    PubMed  CAS  Google Scholar 

  • Young AE. Therapeutic embolisation. British Medical Journal 283: 1144–1145, 1981

    Article  PubMed  CAS  Google Scholar 

  • Yu Y-Q, Xu D-B, Zhou X-D, Lu J-Z, Tang Z-Y, et al. Experience with liver resection after hepatic arterial chemoembolization for heptocellular carcinoma. Cancer 71: 62–65, 1993

    Article  PubMed  CAS  Google Scholar 

  • Zyou Y. Experimental canine hepatic artery embolization with polyvinyl alcohol microspheres. Chung Hua Fang She Hsueh Tsa Chih 23: 330–332, 1989

    Google Scholar 

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Authors and Affiliations

  1. Department of Oncologic Surgery, The Research Institute for Microbial Diseases, Osaka University, Osaka, Japan

    Tetsuo Taguchi

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  1. Tetsuo Taguchi
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Taguchi, T. Chemo-Occlusion for the Treatment of Liver Cancer. Clin. Pharmacokinet. 26, 275–291 (1994). https://doi.org/10.2165/00003088-199426040-00004

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  • DOI: https://doi.org/10.2165/00003088-199426040-00004

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