Effects of multimodal treatment and hyperthermia on hepatic tumors

The therapeutic results of Lp-TAE (transcatheter arterial embolization in the presence or absence of Gelfoam particles preceded by the infusion of a mixture of lipiodol and an anticancer drug via the proper hepatic artery) or DSM-TAE (transcatheter arterial embolization with degradable starch microspheres and the arterial injection of anticancer drugs via the hepatic artery) combined with hyperthermia were evaluated in 30 patients with hepatocellular carcinoma (HCC), 5 subjects with hepatic cholangiocarcinoma, and 22 patients with metastatic liver carcinoma. Hyperthermia was performed using an 8-MHz Thermotron RF-8. Tumor temperatures could be measured in 31 patients (54.4%) with malignant lesions of the liver who had undergone hyperthermia. The mean maximal temperature (Tmax) was 41.5 degrees C in the metastatic liver cancers. The efficiency of heating in HCC was unfavorable, i.e., the mean Tmax was only 40.7 degrees C. The rise in tumor temperature was greater in either HCC or metastatic liver carcinoma associated with portal invasion of the lesion. The tumor-temperature elevation was also excellent in HCC that had been subjected to embolization with DSM in combination with hyperthermia. The response rate (complete response plus partial response) was as high as 40% (4/10) in the group in which the tumor temperature could be raised to 42 degrees C or more. Among the 52 patients who had shown a high pretreatment level of tumor marker, that value decreased in 34 cases (65.4%), and the decrease was greater than 50% in 22 cases (42.3%).