In this retrospective study, eighty-eight patients with advanced hepatocellular carcinoma (HCC) were treated with long-term chemotherapy infusion into the hepatic artery, the main artery that supplies the liver. Known as hepatic arterial chemotherapy, this treatment requires a reservoir/pump system to supply the drug directly to the liver and the liver cancer. The reservoir port systems currently available have to be surgically implanted, making this treatment unavailable to many patients who were unable or unwilling to have the implant. Interventional radiologists -- vascular experts who are uniquely skilled in using the vascular system to deliver targeted treatments via catheter throughout the body -- adapted conventional venous ports to use in the arterial circulation. In this method, the interventional radiologist implanted the reservoir and then embolized – mechanically blocked – the arteries to the adjacent areas during the port placement to prevent the influx of drugs to areas outside of the liver. This is beneficial because the chemotherapy drug is only circulated to the organ with the cancer, so the drug does not harm healthy tissue throughout the body. This allows for a higher dose of chemotherapy drug to be used, because the drug is contained.
Hepatic Arterial Infusion Chemotherapy
The hepatic arterial infusion chemotherapy was initiated after reservoir implantation on an outpatient basis. The infusion protocols were decided for each patient by the physician in charge and chemotherapeutic agents were administered every 1–4 weeks. In 55 patients, cisplatin (10 mg/m2) and 5-fluorouracil (1,000 mg/m2) were given at 1 hour and 5 hours, respectively. In the other 33 patients, doxorubicin hydrochloride or epirubicin hydrochloride (10–20 mg/m2) were injected every 2–4 weeks in a "one-shot" manner.
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