title: Small hepatocellular carcinoma: high dose internal radiation therapy with superselective intra-arterial injection of I-131-labeled Lipiodol.
abstract: The aim of the present study was to deliver a high internal radiation dose to small hepatocellular carcinoma (HCC) lesions in an attempt to treat this disease. A total of 18 patients with HCC lesions measuring less than 4.5 cm in diameter (25 lesions) were treated with superselective intra-arterial injection of I-131-labeled Lipiodol (370-1,100 MBq in 3-5 ml) using a 5-F or coaxial catheter. All the lesions were nodular, multinodular, or hypervascular on pretreatment angiography. In all, 15 lesions that received over 180 Gy of cumulative radiation decreased in size in proportion to the Lipiodol retention on CT, and no pericapsular recurrence was found on angiography after 14-54 months of follow-up. In five patients who subsequently underwent surgery, 65% to 100% tumor necrosis was detected. No abnormal change in liver function tests or untoward clinical symptom of the lung, thyroid, or bone marrow was detected in patients who survived for more than 3 years after the treatment. Superselective high-dose internal radiation therapy of small HCC offers hope of treatment and long-term local control without complications.
authors.affiliation: Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: H S
authors.initials: HS
authors.lastname: Yoo
authors.forename: C H
authors.initials: CH
authors.lastname: Park
authors.forename: J T
authors.initials: JT
authors.lastname: Lee
authors.forename: K W
authors.initials: KW
authors.lastname: Kim
authors.forename: C S
authors.initials: CS
authors.lastname: Yoon
authors.forename: J H
authors.initials: JH
authors.lastname: Suh
authors.forename: C Y
authors.initials: CY
authors.lastname: Park
authors.forename: B S
authors.initials: BS
authors.lastname: Kim
authors.forename: H J
authors.initials: HJ
authors.lastname: Choi
authors.forename: K S
authors.initials: KS
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007269:Injections, Intra-Arterial; D007457:Iodine Radioisotopes / Q000008:administration & dosage / Q000627:therapeutic use*; D007459:Iodized Oil / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage
chemical_list: D007457:Iodine Radioisotopes; D007459:Iodized Oil