Clinical usefullness of intraarterial infusion chemotherapy using implanted reservoir in patients with hepatic malignancies

Seventy-two patients with hepatic malignancies (hepatocellular carcinoma 13, cholangoicellular carcinoma 6, metastatic gastric carcinoma 27, metastatic colorectal carcinoma 18, others 8) were treated with intermittent intraarterial infusion chemotherapy using a subcutaneously implanted silicon reservoir and campared with 268 patients receiving other conventional chemotherapies (bolus one shot chemotherapy into hepatic artery, intravenous chemotherapy, oral chemotherapy, etc). Fiftyfour patients were catheterized from a branch of left subclavian artery and 18 patients were cathterized via the gastroduodenal artery. All patients received a intraarterial infusion chemotherapy employing either MFC or FAM at intervals of two weeks. Among 53 patients, where clinical evaluation of initial response of chemotherapy was possible, partial response (PR) were obtained 23 cases, 43% (hepatocellular carcinoma 5/10, 50%, gastric carcinoma 8/17, 47%, colorectal carcinoma 7/14, 50%, etc). Survival probability at 6 months and 12 months calculated by Kaplan-Meier method were 40% and 10% for hepatocellular carcinoma, 70% and 40% for gastric carcinoma, and 89% and 59% for colorectal carcinoma respectively. These data demonstrated the significantly higher survival rate compared with other chemotherapeutic method by means of generalized Wilcoxon test (p<0.01~0.05). No severe complication was observed in this method without two cases with brain infarction and gastrointestinal bleeding. We concluded that this method was well tolerated procedure in patients with advanced hepatocellular carcinoma and metastatic liver carcinoma.