[Chemoembolization with degradable starch microspheres in malignant hepatic tumors]

Area of Science:

• Interventional Radiology
• Oncology
• Biomaterials

Context:

• Malignant hepatic tumors present a significant treatment challenge.
• Traditional chemotherapy often leads to systemic toxicity and limited efficacy.
• Transcatheter chemoembolization is an established regional therapy for liver cancer.

Purpose:

• To evaluate the efficacy and safety of a novel chemoembolization technique using degradable starch microspheres (DSM) for malignant hepatic tumors.
• To assess the impact of DSM on regional drug uptake and systemic drug exposure.
• To determine tumor response rates and adverse events in patients with hepatocellular carcinoma and metastatic liver cancer.

Summary:

• A new chemoembolization method utilizing 40-45 micron degradable starch microspheres (DSM) was employed in 22 patients (14 hepatocellular carcinoma, 8 metastatic liver cancer).
• DSM temporarily obstructs arterial blood flow, enhancing regional anticancer drug delivery (Adriamycin or Mitomycin C) and reducing systemic exposure.
• Tumor regression exceeding 50% was observed in 5/14 hepatocellular carcinoma and 4/8 metastatic liver cancer cases. Alpha-fetoprotein levels decreased in all treated hepatocellular carcinoma patients. Transient pain was the main side effect; no significant bone marrow suppression or hepatotoxicity occurred.

Impact:

• Chemoembolization with DSM demonstrates potential as an effective and safe treatment modality for malignant hepatic tumors.
• This approach offers improved regional drug delivery, potentially leading to better therapeutic outcomes.
• The use of biodegradable microspheres minimizes long-term complications associated with embolic agents.