Twenty-five patients with
renal cell carcinoma were treated with a lipophilic macromolecular
drug, poly(stylene-co-
maleic acid)-conjugated
neocarzinostatin (
SMANCS) dissolved in
lipid contrast medium (
Lipiodol). The
drug was injected by catheterizing the renal artery and another feeding artery in 24 patients, and in the common hepatic artery in 1 patient with
metastases to the liver after a radical
nephrectomy. The procedure of selective arterial administration of 3-20 mg/mL of
SMANCS/
Lipiodol was simple to perform and was required once every two to three weeks. Total dose of
SMANCS for each patient varied from 3 to 57 mg. Both
SMANCS and
Lipiodol accumulated more selectively in
tumor than in any other tissue and remained in the neovasculature and extracapillary space for a long time. CT pattern of the remaining oil contrast medium in the
tumor was characterized by the high-density area localized mainly in the periphery of the
tumor around the central
necrosis. When hyperviscosity
Lipiodol (
Lipiodol HV) was used as
lipid contrast medium, it remained more persistently in the
tumor and disappeared more slowly than
Lipiodol. Moreover, the pronounced anticancer effect was recognized when
SMANCS/
Lipiodol HV was administered compared with only
SMANCS/
Lipiodol. Severe side effects, such as myelosuppression, unendurable
pain,
paralytic ileus, etc., were not observed. This targeting
chemotherapy may be of great significance for advanced
renal cell carcinoma.