Biodegradable mitomycin C microspheres given intra-arterially for inoperable hepatic cancer. With particular reference to a comparison with continuous infusion of mitomycin C and 5-fluorouracil

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Abstract
Thirty‐two patients with inoperable hepatic cancer underwent intra‐arterial hepatic infusion using mitomycin C (MMC) and 5‐fluorourcil (5‐FU) or intra‐arterial hepatic chemoembolization using heated albumin microspheres containing MMC with an average diameter 45 ± 8 μm. Nineteen of the 32 patients received the MMC microsphere treatment and another 13 received the conventional infusion treatment, lasting for 3.4 months. The administered doses of MMC microspheres were 11.7 ± 11.1 mg as MMC in the 12 with metastatic cancer and 6.9 ± 2.1 mg as MMC in the 7 with hepatocellular cancer (HCC). On the contrary, the 13 patients who underwent conventional infusion had average doses of MMC 34.5 ± 17.3 mg and of 5‐FU 13.4 ± 7.7 g, over 3.4 months. An objective tumor response was obtained in 13/19 (68.4%) under MMC microsphere chemoembolization, compared to 6/13 (46.2%) under the conventional infusion. The average level of CEA in the 12 with metastatic cancer, who underwent MMC microsphere therapy, dropped from 57.7 ng/ml to 16.5 ng/ml, while that in the 10 patients on conventional infusion dropped from 24.0 ng/ml to 17.4 ng/ml; that of alpha‐fetoprotein dropped in all 7 with HCC on MMC microsphere chemoembolization, compared to a fall in 1/3 on conventional infusion. With the MMC microsphere treatment, 5 patients from colorectal cancer lived for 15.6 ± 7.6 months, 2 are alive with a long life expectancy; and 7 patients from gastric or pancreatic cancer lived for only 9.3 ± 3.3 months. In case of conventional infusion, 6 patients from colorectal cancer survived for 8.6 ± 3.2 months; and 4 patients from gastric or gallbladder cancer survived for 6.0 ± 1.0 months. The MMC microsphere treatment is superior at P = 0.059 in survival duration to the conventional infusion treatment. However, much the same survival occurred in 7 on MMC microsphere chemoembolization and 3 on continuous infusion.

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