Abstract
Arterial infusion therapy of SMANCS/Lipiodol(SX/LP) is a prototype DDS therapy of macromolecular drug, which has two remarkable advantages:selective delivery of the drug as pinpointed missile and slow release of drug for a long time (months). However, its arterial infusion only once is not enough for a remarkable regression of tumor, but several subsequent infusions are needed that will usually warrant remarkable outcome. In many hospitals in Japan, its usages have been unsatisfactory and the result is moderate by our standard.
We report here most advanced procedure of SX/LP infusion in detail, which becomes effective to metastatic liver cancer, cholangiocell carcinoma, and cancer of kidney, lung and other organs. Namely, arterial infusion of SX/LP is carried out under angiotensin II induced hypertensive state where normal blood vessels exhibit vasoconstriction and tighter endothelial cell/cell junction, while tumor vessels will open up passively permitting increased blood flow, thus, more drugs (SX/LP) delivery in tumor tissue become possible. On the contrary to delivery to tumor, less drug is delivered to normal tissues as the vascular cell/cell junction is tighter. This method is called SMANCS dynamic therapy and it is now applied not only for hepatocellular carcinoma, but many other tumor as described above even at advanced stage. The method was shown very safe and resulted in remarkable responses with excellent QOL and least toxic.
