Objective: To study the tumor deposition and systemic distribution of colloidal (32)P in single colloidal (32)P injection and macroaggragated albumin (MAA) injection followed by colloidal (32)P and to evaluate their clinical effects and side effects for the treatment of hepatocellular carcinoma.
Methods: H(22) hepatocellular cancer cells were inoculated subcutaneously in the right fore leg of Balb/c mice. When the tumors reached to 1.0 cm in diameter about 10 days postinjection, the mice were divided into two groups randomly. In the first group, the tumors were only injected with 1.85 MBq of colloidal (32)P; while in the second group, with 1 +/- 10(5) particles of MAA followed by 1.85 MBq of colloidal (32)P. The radioactivity in the tumor, blood, heart, liver, kidney, spleen, and bone of each animal was determined at 30min, 24 h, 48 h, 8 d, and 16 d postinjection. Histopathology of tumors was observed at 16 d and 1 month postinjection. The ultrasound-guided intratumoral injection of MAA and colloidal (32)P was performed on 30 patients with hepatocellular cancer. The evaluation of efficacy and side effects was made on the basis of clinical manifestations, histopathological changes, variations in tumor size, serum AFP, the functions of heart, liver, kidney, blood routine, and immune functions before and after the treatment.
Results: Intratumoral injection of colloidal (32)P resulted in necrosis and fibrosis of the tumor cells. Pretreatment with MAA before administration of colloidal (32)P effectively decreased the diffusion of colloidal (32)P from the tumor to blood, and led to retention of colloidal (32)P in the tumor for a longer time. After treatment, a significant shrinkage of the tumor size was seen in all cases with the average shrinkage rate of 53.25%. Serum AFP values decreased remarkably. Clinical symptoms alleviated. The survival rate of 1, 2, and 3 years was 90%, 76.67%, 43.33%. No side effect was found.
Conclusions: Intratumoral injection of MAA and colloidal (32)P is a simple, safe, and effective alternative for the treatment of hepatocellular cancer.