Therapy of hepatocellular carcinoma with iodine-131-lipiodol. Results in a large German cohort.
OBJECTIVE
To evaluate the efficacy and tolerance of iodine-131-lipiodol ((131)I-lipiodol) for hepatocellular carcinoma (HCC) in German long term patients and comparison with medically treated controls.


METHODS
38 courses of intra-arterial (131)I-lipiodol therapy with a total activity up to 6.7 GBq were performed in 18 patients with HCC (6 with portal vein thrombosis). Liver and tumour volume and lipiodol deposition were measured by computed tomography and (131)I activity by scintigraphy. Therapeutic efficacy was determined by tumour volume change and matched-pairs analysis in comparison to medically (i.e. tamoxifen or medical support) treated patients.


RESULTS
Tumour volume decreased in 20/32 index nodules (63%) after the first course. Repeated therapy frequently resulted in further tumour reduction. Overall response to treatment was partial in 11 nodules, minor response in 4 nodules, and disease was stable in 12 and progressive in 5. Significant response was associated with pretherapeutic nodule volume up to 150 ml (diameter of 6.6 cm). Survival rate after 3, 6, 9, 12, 24 and 36 months was 78, 61, 50, 39, 17, and 6%. Matched-pairs analysis of survival revealed (131)I-lipiodol to be superior to medical treatment. The most important side effect was a pancreatitis-like syndrome whereas overall tolerance was good.


CONCLUSIONS
The long term results confirm that HCC therapy with (131)I-lipiodol is effective and probably superior to medical treatment. Tumour nodules of up to 6 cm diameter are well suited for this therapy even in the presence of portal vein thrombosis.
Risse
J H
JH
Radiology and Nuclear Medicine Institute, von-Stauffenberg-Strasse 9, 53604 Bad Honnef, Germany. Joern.Risse@freenet.de
Rabe
C
C
Pauleit
D
D
Reichmann
K
K
Menzel
C
C
Grünwald
F
F
Strunk
H
H
Biersack
H-J
HJ
Palmedo
H
H
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000532:radiotherapy*; D015331:Cohort Studies; D005260:Female; D005858:Germany; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D007459:Iodized Oil / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D017741:Survivors
D007457:Iodine Radioisotopes; D007459:Iodized Oil