Chemoembolization with degradable starch microspheres in metastatic liver cancer

Transcatheter chemoembolization using Degradable Starch Microspheres (DSM) was performed in 22 patients with metastatic liver cancer. DSM, 45 micron in diameter, which are degraded by serum amylase, temporarily obstruct arterial blood flow at the arteriolar capillary bed. Mitomycin C mixed with DSM was injected into the proper hepatic artery. The therapeutic effect of this chemoembolization was evaluated by the change in tumor size measured by angiography or computed tomography. Tumor regression of over 50% was observed in 15 of 22 cases (68%). Elevated serum CEA levels (greater than 10 ng/ml) decreased in 13 of 18 cases (72%). The overall one-year survival rate was 55%. The one-year survival rate was 83% in 8 patients with H2 type liver metastasis. Although half of the patients had transient pain within 2 hours, no major side effects such as bone marrow suppression or hepatotoxicity were observed. Our results suggest that chemoembolization using DSM is effective in the treatment of metastatic liver cancer.