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Chemoembolization in liver malignant involvement. Experiences on 17 cases

G Fiorentini1, A Campanini, C Dazzi

  • 1Department of Medical Oncology, City Hospital Santa Maria delle Croci, Ravenna.

Minerva Chirurgica
|April 1, 1994
PubMed
Summary

Multi-agent hepatic arterial chemoembolization (MACHEM) demonstrated significant activity in patients with massive liver involvement, including hepatocellular carcinoma and metastatic disease. This innovative treatment led to objective tumor regression and acceptable toxicity, offering a promising therapeutic option.

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Area of Science:

  • Interventional Radiology
  • Oncology
  • Hepatology

Background:

  • Liver invasion is a primary cause of organ failure and morbidity in various cancers.
  • Malignant liver lesions are typically supplied by the hepatic artery.
  • Chemoembolization, particularly with Lipiodol ultra-fluid (LUF), is an emerging regional therapy for liver tumors.

Purpose of the Study:

  • To report the outcomes of multi-agent chemoembolization (MACHEM) in patients with extensive liver involvement.
  • To evaluate the efficacy and safety of MACHEM in treating primary and metastatic liver cancers.

Main Methods:

  • Seventeen patients with massive liver involvement underwent MACHEM via a transfemoral approach.
  • The hepatic artery was selectively cannulated, and a mixture of Gelfoam, contrast media, and chemotherapy (mitomycin, cisplatin, epirubicin) in LUF was injected.

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  • Treatment aimed to achieve vascular stasis, inducing tumor infarction and localized drug delivery.

    • Main Results:

    • Objective tumor regression was observed in 11 of 15 evaluable patients.
    • The median survival duration was 9.5 months, with tumor shrinkage evident within 8 weeks.
    • Significant reductions in tumor markers (5-HIAA, CEA, alfa-fetoprotein) were noted in responsive patients.

    Conclusions:

    • MACHEM demonstrated significant activity and acceptable toxicity in heavily pretreated patients with bulky liver tumors.
    • The study suggests that combining chemotherapy with embolizing agents like Gelfoam and LUF enhances therapeutic outcomes.
    • Further improvements in MACHEM protocols, including optimized drug and agent combinations, are warranted for selected patients.