Ultraselective transcatheter infusion of epirubicin in water-in-oil-in-water emulsion for small hepatocellular carcinoma

Br J Radiol. 2012 Sep;85(1017):e584-9. doi: 10.1259/bjr/16376960. Epub 2012 Mar 14.


Objective: We have previously reported the clinical efficacy of water-in-oil-in-water (W/O/W) emulsions, particularly for non-selective transcatheter arterial infusion (TAI) therapy. W/O/W emulsions limit damage to normal hepatic parenchyma, because of their minimal embolic effect on peripheral arteries and slow release of anticancer agent. The purpose of this study was to evaluate the safety and effectiveness of ultraselective TAI (UTI) of a W/O/W emulsion for hepatocellular carcinoma (HCC).

Methods: 11 patients with Stage I-III small HCCs (<5 cm) underwent UTI with a W/O/W emulsion at our institute. Response was assessed using the Response Evaluation Criteria in Solid Tumors. Disease-free survival time was estimated using the Kaplan-Meier method.

Results: All 10 patients, excluding a patient who underwent a hepatectomy after UTI, achieved complete response. The 6, 12 and 30 month cumulative disease-free survival rates for the 10 patients were 100%, 90% and 60%, respectively. The patient who underwent hepatectomy after UTI developed complete necrosis of the HCC and peritumoral non-tumorous liver parenchyma.

Conclusion: UTI therapy using a W/O/W emulsion for patients with small HCCs results in a good local response.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Antibiotics, Antineoplastic / administration & dosage*
  • Carcinoma, Hepatocellular
  • Catheterization, Peripheral*
  • Delayed-Action Preparations / administration & dosage*
  • Delayed-Action Preparations / chemistry
  • Disease-Free Survival
  • Emulsions / chemistry
  • Epirubicin / administration & dosage*
  • Epirubicin / chemistry
  • Female
  • Humans
  • Infusions, Intra-Arterial
  • Liver Neoplasms
  • Male
  • Oils / chemistry
  • Treatment Outcome
  • Water / chemistry


  • Antibiotics, Antineoplastic
  • Delayed-Action Preparations
  • Emulsions
  • Oils
  • Water
  • Epirubicin