[Locoregional therapy with hypoxic liver perfusion in malignant neoplasms of the gallbladder. Preliminary experience].

Abstract

PURPOSE:

We report four cases of advanced malignant cancer of the gallbladder treated with hypoxic hepatic perfusion.

MATERIAL AND METHODS:

Hypoxic hepatic perfusion is currently used to treat diffuse hepatic metastases: the common hepatic artery is occluded with a balloon catheter and then a large amount of antiblastic solution is infused into the liver. Hypoxia and slow flow increase the effect of the drug on neoplastic tissue. Two sessions were performed in three patients with an interval ranging 2-4 months, while one patient underwent a single session. The drug was Mitomycin C, whose dose ranged 20-40 mg (mean: 30 mg). Blood filtration was performed after one of the six procedures only and can be considered unnecessary.

RESULTS:

Acute gastric bleeding appeared in a patient after the embolization of the right gastric artery with bucrylate during the first session performed to avoid drug reflux into gastric wall arteries. No other technical or clinical complications occurred. An objective morphological response (tumor necrosis or reduction in size > 50%) was observed in all patients after the first session. CT findings were stable in two of three patients submitted to a second session, while local progression was observed in the other patient. Complete clinical response was achieved in all symptomatic patients. No WHO toxicity was observed.

DISCUSSION AND CONCLUSIONS:

The rate of positive morphological and/or clinical responses after hypoxic perfusion was very high in our experience, even though our series was small. Recurrences were found in two patients some months later, which suggests the need of long-term follow-up. Hypoxic perfusion can be nevertheless considered as a new and interesting therapeutic approach for advanced malignant gallbladder cancer, with a strong short-term effect on the lesion and good results on clinical symptoms.

• Authors: R Roversi, S Ricci, G Rossi, M Roversi, G Cavallo
• Journal: La Radiologia medica (Radiol Med) Vol. 94 Issue 3 Pg. 220-5 (Sep 1997) ISSN: 0033-8362 [Print] Italy
• Vernacular Title: Terapia locoregionale con perfusione ipossica epatica delle neoplasie maligne della colecisti. Esperienza preliminare.
• PMID: 9446129 (Publication Type: Journal Article)

Chemical References

• Antibiotics, Antineoplastic
• Mitomycin

Topics

• Adenocarcinoma (diagnostic imaging, drug therapy)
• Aged
• Antibiotics, Antineoplastic (administration & dosage, adverse effects)
• Carcinoid Tumor (diagnostic imaging, drug therapy)
• Chemotherapy, Cancer, Regional Perfusion (adverse effects, methods)
• Female
• Gallbladder Neoplasms (diagnostic imaging, drug therapy)
• Humans
• Hypoxia
• Liver (diagnostic imaging)
• Liver Neoplasms (diagnostic imaging, drug therapy, secondary)
• Male
• Middle Aged
• Mitomycin (administration & dosage, adverse effects)
• Palliative Care
• Radiography, Interventional
• Tomography, X-Ray Computed