Transcatheter arterial embolization with zinostatin stimalamer for hepatocellular carcinoma

Takuji Okusaka, Shuichi Okada, Hideki Ueno, Masafumi Ikeda, Ryoko Iwata, Hiroyoshi Furukawa, Kenichi Takayasu, Noriyuki Moriyama, Tosiya Sato, Keiko Sato

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Zinostatin stimalamer (SMANCS) is a lipophilic intra-arterial chemotherapeutic agent for hepatocellular carcinoma (HCC). In our previous study, transcatheter arterial infusion chemotherapy using SMANCS for HCC showed a response rate of 20%. In an effort to obtain a superior anti-tumor effect against HCC, we conducted a phase II study of transcatheter arterial embolization (TAE) using SMANCS and gelatin sponge in 50 chemotherapy-naive patients with HCC. Four milligrams SMANCS plus 4 ml lipiodol emulsion was injected into the hepatic artery, followed by an injection of gelatin sponge. The responses were evaluated by computed tomography (CT) 1 month after treatment and thereafter every 3-4 months. One patient (2%) showed complete response and 15 patients (30%) had partial response resulting in an overall response rate of 32% (16/50; 95% confidence interval 19-45%). In 33 patients (66%), the disease remained stable, and 1 patient (2%) showed progressive disease. In 35 patients (70%), the rate of necrotic area to whole tumor was more than 50% according to the evaluation method using lipiodol accumulation in CT. The 1-, 3- and 5-year survival rates were 90, 55 and 19%, respectively. Grade 3 hematological toxicity was observed as thrombocytopenia in 2 patients (4%). Grade 3 and 4 non-hematological toxicity (liver dysfunction) occurred in 17 (34%) and 7 patients (14%), respectively. TAE using SMANCS, which was well tolerated, may be an effective treatment for advanced HCC.

Original languageEnglish
Pages (from-to)228-233
Number of pages6
Issue number3
StatePublished - 2002
Externally publishedYes


  • Hepatocellular carcinoma
  • Lipiodol accumulation
  • Transcatheter arterial embolization
  • Zinostatin stimalamer


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