Abstract
One hundred and forty patients with hepatocellular carcinoma were treated by transcatheter arterial administration of anticancer drugs. Out of 140 patients, 52 were treated by Mitomycin C (MMC), 32 were treated by Mitomycin C microcapsules (MMCmc), 34 were treated by MMCmc+transcatheter arterial embolization (TAE) and 22 were treated by MMCmc+Adriamycin (ADR)+TAE.
The one year survival rates for the groups treated with MMC, MMCmc, MMCmc+TAE and MMCmc+ADR+TAE were 8.8%, 16.9%, 51.8% and 46.8%, respectively. The percent regression of the tumor size was evaluated on angiograms, computed tomograms and ultrasonograms at 4 or 5 weeks after the first treatment. Frequency of tumor regression of more than 50% after MMC, MMCmc, MMCmc+TAE and MMCmc+ADR+TAE treated groups was 12.5%, 27.6%, 59.3% and 52.6%, respectively, 25% to 50% regression occurred in 12.5%, 20.7%, 33.3% and 21.2%, less than 25% regression in 6.3%, 44.8%, 3.7% and 10.5%, while there was no response in size in 68.8%, 6.9%, 3.7% and 15.7%, respectively.
Serum AFP levels greater than 300ng ml before treatments, fell definitely in the decreasing order of MMC, MMCmc+TAE and MMCmc+ADR+TAE groups in incidence.
The side effects such as myelosuppression, hepatotoxicity and nephrotoxicity were much stronger in the TAE treated cases than in other cases.
The pathological findings were investigated in 15 operated patients including 3 MMC treated cases, 3 MMCmc treated cases, 6 MMCmc+TAE treated cases and 3 MMCmc+ADR+TAE cases. Total necrosis of tumors occurred in all TAE treated cases and in 2 cases of 3 MMCmc treated cases, and partial necrosis in 1 out of 3 MMC treated cases, but some viable cancer cells were seen within the capsule.
