Clinical application of transarterial thermochemotherapy for hepatic cancer

Objective To investigate the effectiveness and safety of transhepatic arterial infusion of warm chemotherapeutic agents in treating hepatic cancer. Methods 35 cases of hepatic cancer were treated with transhepatic arterial thermochemotherapy, with Lipiodol, 5 Fu and carboplatinum warmed to 60～65 °C before infusion into hepatic arteries. 9 patients had two or more treatments and the effectiveness was compared with those of 14 patients receiving simple interventional treatment within the same period. 4 patients had their tumors removed 2～3 months later and the pathological results were compared with those of 4 other patients who had ordinary interventional treatment. Results the tumor growth rate of thermochemotherpay group was -10±33.3% while that of the control group was 36.4±59.0%, showing statistically significant difference. The rates of tumor necrosis on the axial section of resected samples were 93.5±5.97% and 73.5±28.3% respectively but without statistical difference. Pathological changes of both groups were similar microscopically. Only one patient in each group had injury to the artery. Comparing 19 cases of thermochemotherapy group with 22 cases of control group all of whom received “sandwich” therapy, the rates of adverse effect of mild to moderate degree were 72.7% and 63.6%, respectively, those of severe degree were 26.3% and 37.4% , respectively, but these differences were of no statistical significances. Conclusions Transhepatic arterial perfusion of warmed Lipiodol, chemotherapeutic agents (60～65 °C ) combined with hepatic arterial embolization with gelfoam is a simple and safe method in treating hepatic cancer, which can enhance markedly the effectiveness of simple transarterial interventional therapy.