Arterial chemoembolization of hepatocellular carcinoma with mitomycin C microcapsules.

Chemoembolization by selective intra-arterial infusion of mitomycin C in microcapsule form exerts potential therapeutic effects through infarction and prolonged activity. Of 20 patients with inoperable hepatocellular carcinoma (HCC) treated with one or more courses via a hepatic arterial catheter, a change in tumor size could be measured in 16. Measurable tumor regression amounting to greater than 50% was shown in 6 patients (38%), 25-50% in 3 (19%), and less than or equal to 25% in 6 (38%), while tumor increased in 1. Serum alpha-fetoprotein, which was greater than 300 ng/ml before treatment in 13 patients, clearly fell after treatment in 10 (77%). The survival rate at 3, 6, and 12 months after treatment was 75%, 65%, and 24%, respectively, for all patients, and 92%, 85%, and 38% in 11 patients without a tumor cast in the portal vein or its major branches. Systemic toxicity was mild, and all patients tolerated treatment well. These results indicate that chemoembolization with mitomycin C microcapsules is a useful palliative measure for treatment of inoperable HCC.