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Intermittent intra-arterial chemoembolization together with degradable starch microspheres (DSM) and anti-cancer agents (Adriamycin or Mitomycin C) was performed in 4 primary and 6 metastatic liver cancers through a totally implantable arterial infusion port system. For the HCC patients, the response was classified as 2 CR, 2 PR. In the metastatic tumor patients, the response was 1 CR, 2 PR, 1 NC and 2 PD. The overall response was 70%. This treatment is considered very effective, but a delayed mortal side-effect was confirmed in 2 patients with metastases. The histopathological finding of 1 case suggested that the reason for death was severe liver damage by prolonged retention of anti-cancer agent by the liver. It seems likely that sequential DSA evaluation of tumor vascular bed and blood flow recovery allows avoidance of such adverse reactions, as we have attempted it in the present study.
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