title: Intra-arterial injection of 131I-labeled Lipiodol for advanced hepatocellular carcinoma: a 7 years' experience.
abstract: BACKGROUND
  Internal irradiation with iodine-131 (I)-labeled Lipiodol is one of the currently available forms of palliative therapy for patients with advanced hepatocellular carcinoma (HCC). Despite a cumulative experience of more than 10 years with this treatment, only a few studies have reported on its efficacy and safety.
  
  
  OBJECTIVE
  The aim of this study was to retrospectively evaluate the efficacy of intra-arterial I-labeled Lipiodol injection for treatment against advanced HCC.
  
  
  METHODS
  Fifty patients (47 men and three women; mean age 64 years) given an intra-arterial injection of I-Lipiodol (5 ml of 2.2 GBq Lipiodol labeled with I; number of mean sessions per patient, 1.3; range 1-4) were retrospectively compared with 36 patients (31 men and five women; mean age 64 years) who were given only medical support. Portal vein thrombosis was present in 86 and 100% of patients, respectively. Efficacy was determined on the basis of overall survival as the endpoint using the Kaplan-Meier method. Tumor response was evaluated with computed tomography according to Response Evaluation Criteria In Solid Tumors (RECIST 1.1) and European Association for the Study of the Liver (EASL) criteria.
  
  
  RESULTS
  For patients treated with I-Lipiodol, median survival was 32 weeks, compared with 8 weeks for the untreated group (P=0.007). Survival at 6 months and at 1 and 2 years was 65, 35, and 22%, respectively, for patients treated with I-Lipiodol compared with 28, 8, and 0% for the untreated group. At 1 month, more than 80% of patients were responders (complete response, partial response, and stable disease) on the basis of the RECIST and EASL criteria, and at 6 months 39% were responders. No radiotoxic effect was observed, especially with respect to interstitial pneumonia. No significant difference was observed between survival and α-fetoprotein levels, Barcelona Clinic Liver Cancer clinical score, and portal vein thrombosis.
  
  
  CONCLUSIONS
  Intra-arterial injection of I-Lipiodol is safe and provides significant survival benefit in terms of overall survival for patients with advanced HCC.
authors.affiliation: Diagnostic and Interventional Department of Neuroradiology, G and R Laënnec Hospital, Hôtel-Dieu, CHU Nantes, Nantes, France.
authors.forename: Alina
authors.initials: A
authors.lastname: Lintia-Gaultier
authors.forename: Christophe
authors.initials: C
authors.lastname: Perret
authors.forename: Catherine
authors.initials: C
authors.lastname: Ansquer
authors.forename: Thomas
authors.initials: T
authors.lastname: Eugène
authors.forename: Françoise
authors.initials: F
authors.lastname: Kraeber-Bodéré
authors.forename: Eric
authors.initials: E
authors.lastname: Frampas
mesh_terms: D000368:Aged; D001158:Arteries; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology* / Q000532:radiotherapy*; D004998:Ethiodized Oil / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D007457:Iodine Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use; D007553:Isotope Labeling; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012449:Safety; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D007457:Iodine Radioisotopes; D004998:Ethiodized Oil