[Limitation of oily chemoembolization against hepatocellular carcinoma and arterioportal segmental chemoembolization]

Emulsion of adriamycin and lipiodol added with Gelfoam has been used for the transcatheter oily chemoembolization against hepatocellular carcinomas. This therapy resulted in significantly increased cumulative survival as compared with chemoembolization therapy using anti-cancer drugs and Gelfoam. However, it was revealed to have the following limitations: Insufficient efficacy against micrometastases and extracapsular invasion; impossible to perform sufficient treatment for patients with severe hepatic disorders; and there were cases in which lipiodol was hardly retained. In order to overcome the limitations described above, we have performed segmental hepatic chemoembolization simultaneously from the hepatic artery embolization simultaneously from the hepatic artery and portal vein. This method works on the basis of the fact that excess amount of lipiodol emulsion infused from the hepatic artery flows into the portal vein. Gelfoam embolization is also added in this method. Though subjects appropriate for this newly developed method are restricted, all the tumors in the objective segment of the liver can undergo necrosis. The efficacy is comparable to the effects of hepatectomy. In addition, since the other segments of the liver are able to be kept in reserve, this method is able to be applied to patients with severe hepatic disorders.