Warming effect on miriplatin-lipiodol suspension as a chemotherapeutic agent for transarterial chemoembolization for hepatocellular carcinoma: preliminary clinical experience.

Abstract

PURPOSE:

To retrospectively elucidate the preliminary clinical impact of warmed miriplatin-lipiodol suspension (MPT-LPD) when used as a chemotherapeutic agent for transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).

MATERIALS AND METHODS:

Between June and December 2010, TACE was performed with MPT-LPD at room temperature (RT group), and after January 2011, TACE with MPT-LPD warmed to 40 °C was performed (W group). The intraarterial appearance of MPT-LPD immediately after injection through microcatheters at the second-order branches was compared between the two groups with a 5-point grading system. Local therapeutic effects of HCCs as assessed by follow-up computed tomography (CT) obtained 1-3 months after TACE were compared between the groups with a 4-point grading system (TE1-TE4). After April 2011, angiography-assisted CT was routinely performed at TACE, and HCCs that revealed apparent corona enhancement (CE) were retrospectively selected. The degree of concordance between CE and MPT-LPD accumulation as assessed by CT immediately after TACE was assessed with a 3-point grading scale.

RESULTS:

MPT-LPD therapy resulted in a smooth and continuous appearance in the W group (grades 1, 2, 3, 4, and 5 were, respectively, 1, 2, 11, 18, and 4) compared to the RT group (4, 0, 1, 2, and 0). The W group (TE1, TE2, TE3, and TE4 were 1, 9, 11, and 12) revealed better local therapeutic effects than the RT group (6, 3, 9, and 0) (p < 0.05). CE was found in 26 HCC nodules, and concordance between CE and MPT-LPD accumulation was observed in 66% (grades 1, 2, and 3 were, respectively, 2, 8, and 19).

CONCLUSION:

Warmed MPT-LPD flowed more smoothly within vascular lumen, passed through tumor sinusoid of HCC, and had better local therapeutic effects at short-term observation than MPT-LPD at room temperature.

• Authors: Shinn-ichi Kora, Hiroshi Urakawa, Toshimichi Mitsufuji, Akinobu Osame, Hideyuki Higashihara, Kengo Yoshimitsu
• Journal: Cardiovascular and interventional radiology (Cardiovasc Intervent Radiol) Vol. 36 Issue 4 Pg. 1023-9 (Aug 2013) ISSN: 1432-086X [Electronic] United States
• PMID: 23238851 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Organoplatinum Compounds
• Suspensions
• miriplatin
• Ethiodized Oil

Topics

• Aged
• Angiography, Digital Subtraction
• Carcinoma, Hepatocellular (diagnostic imaging, mortality, therapy)
• Chemoembolization, Therapeutic (methods)
• Cohort Studies
• Disease-Free Survival
• Ethiodized Oil (therapeutic use)
• Female
• Hot Temperature
• Humans
• Infusions, Intra-Arterial
• Liver Neoplasms (diagnostic imaging, mortality, therapy)
• Male
• Middle Aged
• Neoplasm Invasiveness (pathology)
• Neoplasm Staging
• Organoplatinum Compounds (therapeutic use)
• Prognosis
• Prospective Studies
• Risk Assessment
• Survival Analysis
• Suspensions
• Tomography, X-Ray Computed (methods)
• Treatment Outcome