[A new method of intraarterial high dose chemotherapy for unresectable hepatomas using direct hemoperfusion under hepatic venous isolation (HVI.DVP)]

We have recently developed a simple method of high dose chemotherapy using HVI.DHP. The effect of HVI.DHP was evaluated in the elimination of anticancer drugs. Adriamycin (ADR: 3mg/kg), mitomycin C (MMC:1mg/kg) and cisplatin (CDDP: 2mg/kg) were given to mongrel dogs through the hepatic artery with or without HVI.DHP. The drug removal rates were similar in three drugs. Area under the curve and peak systemic level of each drug were substantially reduced by means of HVI.DHP, the values of ADR, MMC and CDDP being 17.4 and 6.2%, 4.5 and 5.9%, and 24.6 and 23.1%, respectively, of the corresponding values of simple hepatic artery infusions. Ten patients with unresectable hepatomas were treated by intraarterial high dose ADR (100-150mg/m2) using HVI.DHP. All except for two patients with catheter related complications recovered uneventfully and showed marked reductions of serum alpha-fetoprotein. Complete response was observed in one and partial response in five patients, for an overall response rate of 60%. Systemic toxicities of ADR were minimized: no cardiotoxicity, leucopenia less than 1000 cells/mm3 in one and mild hair loss in six patients. On the basis of these results, we consider this method to be an attractive therapeutic option for hepatic tumors.