To evaluate the effect of
styrene maleic
neocarzinostatin-transcatheter arterial embolization (
SMANCS-TAE), 40 patients with unresectable
hepatocellular carcinoma (HCC) of hypervascular radiological feature, associated with
liver cirrhosis (LC), 18 in clinical stage 2 and 20 in stage 3, were treated by
SMANCS-TAE.
SMANCS with
Lipiodol and then
gelatin sponge particles were injected into the artery branch supplying HCC using selective catheterization, and its effect was evaluated by computed tomography (CT) Grade. In patients with Grade III or less (
Lipiodol accumulation < 99% in the entire
tumor) after the first course of
therapy,
SMANCS-TAE or arterial injection of
SMANCS-
Lipiodol was performed once or twice more. Consequently, 32 of 40 patients (80%) obtained Grade IV (100%
Lipiodol accumulation in the entire
tumor) after from once to thrice (median, 1.6 courses). Grade IV was maintained in 26 of 32 patients, and non-recurrence was found 16 of 40 (40%) at the primary
tumor to the time at last of follow up. Severe side effects were not noted except in 10 cases with narrowness of hepatic artery and cases of 2 biloma in patients undergoing
therapy two or more times. The 1-, 2-, 3-, and 5-year survival rate was 85, 64, 35, and 26%, respectively. No significant difference was noted in the survival rate between clinical stage 2 and 3
liver cirrhosis (LC). But the survival rate of patients who continued to exhibit Grade IV at the primary
tumor was significantly better than in those exhibiting Grade III or less (96, 68, 56, and 43% vs 64, 29, 0, and 0%, respectively; p < 0.01). In conclusion, the HCC patients, even those with decompensated LC, who obtained and maintained Grade IV after
SMANCS-TAE could reduce the courses of treatment without severe side effects and survived longer.
SMANCS-TAE might be useful for the good quality of life of HCC patients.