CHEMOSENSITIVITY TEST FOR REPEATED ARTERIAL INFUSION CHEMOTHERAPY BY RESERVOIR FOR UNRESECTABLE HEPATOCELLULAR-CARCINOMA

The experimental and clinical usefulness of a chemosensitivity test (N uclear Damage Assay) was studied. Karyologic degenerative changes were observed as an indicator of drug sensitivity, in repeated arterial in fusion chemotherapy (RAIC) using a reservoir for advanced hepatocellul ar carcinoma (HCC). In the experimental study, this sensitivity test w as performed using five liver cell lines against 15 drugs. At the same time, the succinate dehydrogenase inhibition (SDI) test was also perf ormed. Comparison of the results between these two tests gave a high c onsistency rate of 81%. Clinically, the karyologic sensitivity test wa s carried out in 135 patients with unresectable HCC. Drug sensitivity could be evaluated in as many as 89% of the total 135 patients. Of the patients, 43 received RAIC on an outpatient basis via a subcutaneousl y implanted reservoir. The objective response of RAIC on rumours of th e 43 patients was evaluated as complete response, partial response, in 3 (9%) and 8 (23%) in 35 patients treated with positive drugs (positi ve group), and as 0 (0%) and 0 (0%) of 8 patients treated with negativ e drugs (negative group), respectively. As regards the prognosis, 1 ye ar and 1.5 year survival rates were 70 and 45% in the positive group, and 42 and 0% in the negative group, respectively. As objective respon se in the positive group tended to be better than that in the negative group, and prognosis in the positive group was significantly better t han that in the negative group, this sensitivity test appears to contr ibute to the improvement of therapeutic results if used to select drug s suitable for RAIC for advanced HCC.