Intraarterial infusion chemotherapy with lipiodol-CDDP suspension for hepatocellular carcinoma
K Yamamoto1, T Shimizu, I Narabayashi
1Department of Radiology, Osaka Medical College, 2-7 Daigaku-chou, Takatsuki-City, Osaka 569-0801, Japan.
Purpose:
To quantitatively evaluate the usefulness of lipiodol-CDDP suspension (LCS) chemotherapy in hepatocellular carcinoma (HCC).
Methods:
CDDP (cis-diamminedichloroplatinum) powder was prepared by removing the water and NaCl from aqueous CDDP. Two quantities of prepared CDDP powder, 10 mg and 20 mg, were mixed with 1 ml each of iopamidol 300 mgI/ml (IP300) and lipiodol (LPD) using a high pressure pumping method, thus producing LCS. Thirty-two patients with HCC, who had good renal function [creatinine clearance (Ccr) 50 ml/min or more], received additional intraarterial infusion chemotherapy with LCS or LCS alone.
Results:
The most frequently observed CDDP powder sizes were 5.95-10.90 microm (average: 11.59 microm). The LCS obtained demonstrated a suspension of 2-12 microm (average 3.69 microm) immediately after mixing, and no significant changes were observed in LCS particle sizes 3 hr after mixing. Moreover, the sustained release with LCS was observed for up to 3 hr. Meanwhile, the peripheral free platinum concentration between intraarterial infusion chemotherapy with LCS and intraarterial infusion with the aqueous solution of CDDP, with respect to variance residence time (VRT), showed a significant difference, with a p value of 0.0382. The survival rate was 89.84% at 1 year, 73.78% at 2 years, and 68.51% at 3 years. Furthermore, the platinum concentration in the tumor was 25-95 times the concentration in the surrounding liver parenchyma.
Conclusion:
Good clinical results can be expected by applying LCS to HCC.