Abstract
Arterial infusion chemotherapy has become one of the major treatments for malignant tumors. Since 1988, we have attempted repeated arterial infusion of anticancer drugs using an implantable drug delivery system in 68 patients who had inoperable hepatocellular carcinoma (HCC). Most of our patients could not undergo transcatheter arterial embolization (TAE) because of extreme tumor extension and/or accompanying advanced liver cirrhosis. In most patients we implanted a 5-F catheter via the femoral artery nonsurgically and connected it to a subcutaneously implanted drug delivery system without any difficulty. The treatment consisted of weekly or biweekly intrahepatic one-shot administration of anticancer drugs. As one therapeutic regimen, epirubicin was given alone. Other regimens consisted of combined chemotherapy using two or more of the following drugs: mitomycin C, Adriamycin, 5-fluorouracil, cisplatin, and epirubicin. In some cases, these drugs mixed with Lipiodol were given for targeting and slow release in the liver. The response rate (CR+PR) of the cases was 25.0%. The median survival period was 389.9 days. The 6-month, 1-year, and 2-year survival rates were 75%, 45%, and 17%, respectively. There was no severe side effect or complication except arterial occlusion that precluded further infusion chemotherapy. We think that the implantable drug delivery system will contribute not only to improved therapeutic efficacy for inoperable HCC but also to an improved quality of life for the patients.
Similar content being viewed by others
References
Aoki T, Kimura K, Koyanagi Y, Aoki T, Kusama M, Ashizawa T, Takagi S, Kakuta T, Matsunaga T, Yasuda D, Ohno M, Shibata K (1989) Various methods of catheter placement in hepatic arterial infusion technique of catheter placement via a femoral artery. Jpn J Cancer Chemother 16: 3149
Arai Y, Kido C, Endo T (1988) Hepatic arterial infusion (HAI) chemotherapy for liver metastasis from colon, gastric and breast cancer (ca). Proc Am Soc Clin Oncol 7: 102
Bern MM, McDermott W Jr, Cady B, Oberfield RA, Trey C, Clouse ME, Tullis JL Parker LM (1978) Intraarterial hepatic infusion and intravenous Adriamycin for treatment of hepatocellular carcinoma. A clinical and pharmacology report. Cancer 42: 399
Cady B, Oberfield RA (1974) Arterial infusion chemotherapy of hepatoma. Surg Gynecol Obstet 138: 381
Chan KK, Chlebowski RT, Tong M, Chen HSG, Gross JF, Bateman JR (1980) Clinical pharmacokinetics of Adriamycin in hepatoma patients with cirrhosis. Cancer Res 40: 1263
Child CG, Turcatte JG (1964) Surgery and portal hypertension. In: Child CG (ed) The liver and portal hypertension. W. B. Saunders, Philadelphia, p 50
Ensminger W, Niederhuber J, Dakhil S, Thrall J, Wheeler R (1981) Totally implanted drug delivery system for hepatic arterial chemotherapy. Cancer Treat Rep 65: 393
Granmayeh M, Wallace S, Schwarten D (1979) Transcatheter occlusion of the gastroduodenal artery. Radiology 131: 59
Hirai K, Kawazoe Y, Yamashita K, Aoki Y, Fujimoto T, Sakai T, Majima Y, Abe M, Tanikawa K (1989) Arterial chemotherapy and transcatheter arterial embolization therapy for nonresectable hepatocellular carcinoma. Cancer Chemother Pharmacol 23 [Suppl]: S37
Kanematsu T, Inokuchi K, Sugimachi K, Furuta T, Sonoda T, Tamura S, Hasuo K (1984) Selective effects of lipiodolized antitumor agents. J Surg Oncol 25: 218
Kishimoto W, Nonami T, Nakao A, Harada A, Kuroe K, Haba T, Takagi H (1988) Arterial infusion of anticancer agent and Lipiodol using a totally implanted drug delivery system. Jpn J Cancer Chemother 15: 2531
Liver Cancer Study Group of Japan (1983) The general rules for clinical and pathological study of primary liver cancer, Kanehara & Co., Tokyo
Liver Cancer Study Group of Japan (1986) Survey and follow-up study of primary liver cancer in Japan. Report 7. Acta Hepatol Jpn 27: 1161
Miyamoto H, Ogawa M, Inagaki J, Horikoshi N, Ezaki K, Inoue K, Nagata T, Aiba K, Domyo M (1982) Aiterial infusion of combination chemotherapy using Adriamycin and mitomycin C for hepatoma and metastatic tumors of the liver. Jpn J Cancer Chemother 9: 1955
Nakamura K, Takashima S, Takada K, Fujimoto K, Kaminou T, Nakatsuka H, Minakuchi K, Onoyama Y (1992) Clinical evaluation of intermittent arterial infusion chemotherapy with an implantable reservoir for hepatocellular carcinoma. Cancer Chemother Pharmacol 31 [Suppl I]: S93
Nishiwaki H, Asai T, Sataka K, Sowa M (1992) Gastric microcirculation and acute gastric mucosal lesions in patients with hepatic cirrhosis. Hepatogastroenterology 39: 242
Sakurai M, Okamura J, Kuroda C (1984) Transcatheter chemoembolization effective for treating hepatocellular carcinoma. A histopathologic study. Cancer 54: 387
Shimamura, Y, Takenaka Y, Ishii M, Shima Y, Taniguchi H, Kitai Y, Watanabe H, Sugai S, Takashi A, Kitaya T, Matsuyama T, Hasegawa H (1989) Multimodal treatment of hepatocellular carcinoma. Cancer Chemother Pharmacol 23 [Suppl]: S87
Yamada R, Sato M, Kawabata M, Nakatsuka N, Nakamura K, Takashima S (1983) Hepatic artery embolization in 120 patients with inresectable hepatoma. Radiology 148: 397
Yang CF, Ho YZ, Chang JM, Chiang RH, Lai KH, Lee SD, Tsai YT, Lui WY, Liu TJ, Chen GH (1989) Transcatheter arterial chemoembolization for hepatocellular carcinoma. Cancer Chemother Pharmacol 23 [Suppl]: S26
Ziessman HA, Thrall JH, Yang PJ, Walker SC, Cozzi EA, Niederhuber JE, Gyves JW, Ensminger WD, Tuscan MC (1984) Hepatic arterial perfusion scintigraphy with Tc-99m-MAA. Use of a totally implanted drug delivery system. Radiology 152: 167
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Iwamiya, T., Sawada, S. & Ohta, Y. Repeated arterial infusion chemotherapy for inoperable hepatocellular carcinoma using an implantable drug delivery system. Cancer Chemother. Pharmacol. 33 (Suppl 1), S134–S138 (1994). https://doi.org/10.1007/BF00686685
Issue Date:
DOI: https://doi.org/10.1007/BF00686685