Randomized control trial of lipo-prostaglandin E1 in patients with acute liver injury induced by lipiodol-targeted chemotherapy.
OBJECTIVE
The aim of this study was to prove whether lipo-prostaglandin E1 (PGE1)/glucagon insulin therapy combination could prevent the acute liver dysfunction induced by Lipiodol (iodized oil)-targeted chemotherapy for hepatocellular carcinoma.


METHODS
This study was a randomized control trial. Patients in two groups (groups A and B: n = 29) were each given an intravenous injection of 10 units of insulin and 1 mg glucagon every 12 hours for 1 week after Lipiodol-targeted chemotherapy. Patients in group B (n = 11) were each given an intravenous injection of 20 micrograms lipo-PGE1 every 12 hours over 1 week. Several items, including conventional liver function tests, were evaluated at the start of the study and on the days 1, 2, 4, 7, and 14 after Lipiodol-targeted chemotherapy.


RESULTS
Combined lipo-PGE1/glucagon-insulin therapy can prevent the elevation of serum ALT level and total bilirubin level after Lipiodol-targeted chemotherapy. In the group A (glucagon-insulin therapy only), the maximum level in the follow-up interval was statistically higher than that in the pretreatment level (p < 0.05), whereas there was no significant difference in group B (treated with combined glucagon-insulin therapy and lipo-PGE1). Changes of ALT level in group B tend to be lower than in group A; however, there was no significant statistical difference. There were few episodes of side effects in both groups.


CONCLUSIONS
Combined lipo-PGE1/glucagon-insulin therapy may be a safe and effective treatment for the prevention of acute hepatic failure.
Ikegami
T
T
Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan.
Matsuzaki
Y
Y
Kurusu
J
J
Yoshiga
S
S
Saito
Y
Y
Chiba
T
T
Abei
M
M
Shoda
J
J
Tanaka
N
N
Osuga
T
T
D000368:Aged; D000527:Alprostadil / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D005934:Glucagon / Q000008:administration & dosage; D006801:Humans; D007275:Injections, Intravenous; D007328:Insulin / Q000008:administration & dosage; D007459:Iodized Oil / Q000009:adverse effects* / Q000627:therapeutic use; D017093:Liver Failure / Q000139:chemically induced / Q000517:prevention & control*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged
D007328:Insulin; D007459:Iodized Oil; D005934:Glucagon; D000527:Alprostadil