PERCUTANEOUS MITOXANTRONE INJECTION FOR PRIMARY AND SECONDARY LIVER-TUMORS - PRELIMINARY-RESULTS

Purpose: To determine the effects of percutaneous intratumoral chemoth erapy with mitoxantrone (PIM) in the palliative treatment of malignant liver lesions. Methods: We treated 15 progressive lesions in nine pat ients in whom either previous therapy failed or serious complications developed as a result. Seven lesions were metastatic and eight were du e to foci of hepatocellular carcinoma. Under computed tomography (CT) guidance, we percutaneously injected 10 - 20 mg of mitoxantrone mixed with 0.5 ml of contrast medium into the tumor, performing one to three treatments at intervals of 1 month. Results: There were no complicati ons, The morphologic responses of the tumors after treatment were: min or response in one case, no change in 11 cases, progressive disease in three cases. Mitoxantrone induced tumor necrosis with no viable cance r tissue in eight of 11 biopsies. Recurrence was observed in nine of t he treated lesions 2-9 months after treatment. New lesions were observ ed in five of nine patients 1-9 months after treatment. Conclusion: In patients with malignant liver lesions with no other therapeutic possi bilities, minimally invasive intratumoral mitoxantrone injection was c arried out safely with good tumor delivery of chemotherapy, and tumor necrosis was demonstrated at biopsy. We feel this approach warrants fu rther investigation.