Transcatheter Arterial Chemotherapy with Miriplatin for Hepatocellular Carcinoma Patients with Chronic Renal Failure: Report of Three Cases
An 84-year-old man with HCC, liver cirrhosis, and chronic renal failure had undergone RFA three times and TACE six times over 10 years. As shown in , a CT scan of the liver showed multiple HCCs (tumor size, 12 to 55 mm; tumor number, six; stage, T3N0M0). The serum creatinine level was 1.6 mg/dL, and the estimated GFR was 20.3 mL/min ().\nThe patient was hydrated through a peripheral line. The femoral artery was catheterized under local anesthesia, and catheter was inserted superselectively into the hepatic artery that supplied the target tumor, for injection of the miriplatin/lipiodol suspension. Miriplatin/lipiodol suspension was administrated slowly under careful fluoroscopic guidance. The dose of miriplatin/lipiodol was determined according to tumor size and the degree of liver dysfunction.\nThe patient received transcatheter arterial chemotherapy with miriplatin (miriplatin 50 mg and lipiodol 2.5 mL were injected from both the right and left hepatic arteries). Therapy was well tolerated, and the patient's weight and serum creatinine level remained stable after treatment (). The major side effect of treatment was grade 1 fever, which resolved within 1 week (CTCAE version 4.0). Treatment efficacy was assessed 2 months after therapy. Stable disease (mRECIST) was achieved in all target lesions.