Clinical application of transarterial thermochemotherapy in hepatic cancer

OBJECTIVE: To investigate the effectiveness and safety of transhepatic arterial infusion with warm chemotherapeutic agents in treating hepatic cancer. METHODS: Thirty-five cases of hepatic cancer were treated with transhepatic arterial thermochemotherapy. Lipiodol, 5-Fu and carbonplatinum were warmed to 60–65°C before infusion into the hepatic arteries. Nine patients had two or more treatments and the effectiveness of this treatment was compared with that observed in 14 patients who received ordinary interventional treatment within the same period. Four patients had their tumors removed 2–3 months later and the pathological results were compared with those of four other patients who received regular treatment. RESULTS: The tumor growth rate of the thermochemotherapy group was –10 ± 33.3%, while that of the control group was 36.4 ± 59.0%, a statistically significant difference. The tumor necrosis rates on the axial sections of the resected samples were 93.5%± 5.97% and 73.5%± 28.3%, respectively, but the difference was not statistically significant. Microscopically, the pathological changes in the two groups were similar. Only one patient in each group had arterial injury. Comparing the thermochemotherapy group (19 cases) with the control group (22 cases), all of whom received ‘sandwich’ therapy, we found that the prevalence of mild–moderate adverse effects was 72.7 and 63.6%, respectively, while that of severe adverse effects was 26.3 and 37.4%, respectively. However, these differences were of no statistical significance. CONCLUSIONS: Transhepatic arterial perfusion of warmed Lipiodol and chemotherapeutic agents (60–65°C) combined with hepatic arterial embolization with gelfoam is a simple and safe method for treating hepatic cancer. It can markedly enhance the effectiveness of simple transarterial interventional therapy.