Superselective intra-arterial radiometabolic therapy with I-131 lipiodol in hepatocellular carcinoma.
Superselective transcatheter arterial radioembolization with radioiodinated lipiodol and gelatin sponges was evaluated in 11 patients with nodular hepatocellular carcinoma. Thirteen tumor nodules were treated using 3-5 ml of lipiodol labeled with 259 to 2220 MBq of I-131 followed by gelatin sponge with the following results: 1) there was elevated uptake in 12 tumor nodules with high tumor-to-background ratios: 2) there was excellent clinical tolerance to the treatment (stable cirrhosis in 5 patients and cirrhosis progression in 2 cases); 3) there was good disease control with size reduction in five tumor lesions (41%) and no increase in seven lesions (59%) followed for 2 years; 4) there was a 2-year survival rate of 70%; and 5) three deaths due to hepatic failure at 2, 3, and 20 months after therapy. Superselective arterial radioembolization with I-131 lipiodol is a useful palliative approach to inoperable hepatocarcinoma, providing long-term local control without severe complications in the progression of cirrhosis.
Maini
C L
CL
Department of Nuclear Medicine, Regina Elena, National Cancer Institute, Rome, Italy.
Scelsa
M G
MG
Fiumara
C
C
Tofani
A
A
Sciuto
R
R
Tipaldi
L
L
D'Annibale
M
M
Santoro
E
E
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D005781:Gelatin Sponge, Absorbable; D006801:Humans; D007269:Injections, Intra-Arterial; D007457:Iodine Radioisotopes / Q000008:administration & dosage* / Q000627:therapeutic use; D007459:Iodized Oil / Q000008:administration & dosage* / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D008297:Male; D010166:Palliative Care / Q000379:methods*; D011877:Radionuclide Imaging; D011879:Radiotherapy Dosage; D015996:Survival Rate; D013997:Time Factors
D007457:Iodine Radioisotopes; D007459:Iodized Oil