Survival after 131I-labeled lipiodol therapy for hepatocellular carcinoma. A single-center study based on a long-term follow-up.
This study investigated the efficacy of 131iodine-labeled lipiodol (131I-lipiodol) as a palliative therapy, evaluated overall survival (OS) across Barcelona Clinic Liver Cancer (BCLC) stages, and determined the main prognostic factors influencing OS in patients with hepatocellular carcinoma (HCC).


METHODS
We retrospectively analyzed 57 (44 men; mean age, 65.7 years; mean activity per session, 1.6 GBq; mean cumulative activity in patients with >1 sessions, 3.9 GBq) HCC patients who underwent 131I-lipiodol therapy. A majority of patients exhibited Child-Pugh class B (53.6%) disease and a good Eastern Cooperative Oncology Group performance status (0-1; 72%). Multinodular disease was observed in 87.7% patients, bilobar disease in 73%, and portal vein occlusion (PVO) in 54%. Furthermore, 21.1% patients were staged as BCLC B and 59.6 % as BCLC C. All patients were followed until death.


RESULTS
The median OS was 6.4 months, which varied significantly with disease stage (median OS for BCLC A, B, C, and D was 29.4, 12.0, 4.6, and 2.7 months, respectively; p = 0.009); Child-Pugh score and class; presence of ascites, PVO, or extrahepatic disease; largest lesion size; favourable treatment response; international normalized ratio, baseline albumin and alpha-fetoprotein levels. Patients with a Child-Pugh A liver disease had a longer OS.


CONCLUSIONS
Currently, different treatment modalities for HCC include radioembolization, transarterial chemoembolization, and systemic therapy with sorafenib; however, 131I-lipiodol therapy remains a feasible alternative for patients without a favourable response to other therapies, particularly for patients with Child-Pugh A liver cirrhosis.
Hojjat Ahmadzadehfar, M.D., Department of Nuclear Medicine, University Hospital Bonn Germany, Sigmund-Freud-Str. 25, 53127 Bonn, Tel. 49/(0)228/28 71 98 58, Fax 49/(0)228/28 79 01 98 58, E-mail: hojjat.ahmadzadehfar@ukb.uni-bonn.de.
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H
Ahmadzadehfar
E
E
Habibi
S
S
Ezziddin
K
K
Wilhelm
R
R
Fimmers
U
U
Spengler
H
H
Palmedo
H
H
Strunk
H H
HH
Schild
H J
HJ
Biersack
J
J
Risse
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D059248:Chemoradiotherapy; D004998:Ethiodized Oil / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D019275:Radiopharmaceuticals; D004998:Ethiodized Oil
131I-lipiodol; BCLC; Liver cancer; hepatocellular carcinoma; radionuclide therapy