Adjuvant Intraarterial Lipiodol or ¹³¹I-Lipiodol After Curative Treatment of Hepatocellular Carcinoma: A Prospective Randomized Trial.
The prevention of tumor recurrence after curative treatment of hepatocellular carcinoma (HCC) is unresolved. Postoperative intraarterial injection of (131)I-labeled lipiodol has been proposed as adjuvant treatment. The aim of this prospective randomized trial was to evaluate if a single dose of postoperative adjuvant intraarterial (131)I-lipiodol (vs. unlabeled lipiodol) could reduce the rate of intrahepatic recurrence at 2 y.


METHODS
Patients who underwent curative treatment for HCC and recovered within 6 wk were randomly assigned to receive a single 2,200-MBq (131)I-lipiodol dose or a single unlabeled lipiodol dose on a 1:1 basis. Recurrence-free and overall survival rates were analyzed.


RESULTS
Between June 2005 and February 2009, we included 58 patients (median age of 63 y [range, 23-85 y]): 29 received intraarterial (131)I-lipiodol and 29 received lipiodol adjuvant treatment. At 2 y after treatment, the rate of patients with intrahepatic recurrence was 28% in the (131)I-lipiodol group and 56% in the lipiodol group (P = 0.0449). The Kaplan-Meier analysis confirmed this result, with a 2-y recurrence-free survival in the (131)I-lipiodol and lipiodol groups of 73% and 45%, respectively (P = 0.0259). The 5-y recurrence-free survival rates in the (131)I-lipiodol and lipiodol groups were 40% and 0%, respectively (P = 0.0184). The overall and specific survivals were not significantly different between groups (P = 0.9378 and P = 0.1339, respectively). (131)I-lipiodol had no severe toxic effects.


CONCLUSIONS
After curative treatment of patients with HCC, one 2,200-MBq dose of intraarterial (131)I-lipiodol significantly decreased the rate of intrahepatic recurrence but failed to improve overall or specific survival.
Hospices Civils de Lyon, Hôpital Edouard Herriot, Fédération des Spécialités Digestives, Lyon, France Université Lyon 1, Lyon, France jerome.dumortier@chu-lyon.fr.
Jérôme
J
Dumortier
Hospices Civils de Lyon, Unité de Recherche Clinique, Pôle IMER, Lyon, France EAM Santé Individu Société 4128, Lyon, France.
Evelyne
E
Decullier
Service d'Hépato-Gastro-Entérologie, CHU de Grenoble, Hôpital A. Michallon, La Tronche, France.
Marie-Noëlle
MN
Hilleret
Hospices Civils de Lyon, Unité de Recherche Clinique, Pôle IMER, Lyon, France EAM Santé Individu Société 4128, Lyon, France.
Sylvie
S
Bin-Dorel
Hospices Civils de Lyon, Hôpital Edouard Herriot, Fédération des Spécialités Digestives, Lyon, France Université Lyon 1, Lyon, France.
Pierre-Jean
PJ
Valette
Hospices Civils de Lyon, Hôpital Edouard Herriot, Fédération des Spécialités Digestives, Lyon, France Université Lyon 1, Lyon, France.
Olivier
O
Boillot
Hospices Civils de Lyon, Hôpital Edouard Herriot, Fédération des Spécialités Digestives, Lyon, France Université Lyon 1, Lyon, France.
Christian
C
Partensky
Service de Chirurgie Digestive, CHU de Grenoble, Hôpital A. Michallon, La Tronche, France Université Joseph Fourier, Grenoble, France.
Christian
C
Letoublon
Université Lyon 1, Lyon, France Service de Chirurgie Digestive, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France.
Christian
C
Ducerf
Service d'Hépato-Gastro-Entérologie, CHU de Grenoble, Hôpital A. Michallon, La Tronche, France Université Joseph Fourier, Grenoble, France.
Vincent
V
Leroy
Université Joseph Fourier, Grenoble, France Service de Médecine Nucléaire, CHU de Grenoble, Hôpital A. Michallon, La Tronche, France; and.
Jean-Philippe
JP
Vuillez
Université Lyon 1, Lyon, France Service de Médecine Nucléaire, Hospices Civils de Lyon, Hôpital Cardiologique Louis Pradel, Bron, France.
Françoise
F
Borson-Chazot
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant / Q000009:adverse effects / Q000379:methods*; D004998:Ethiodized Oil / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007269:Injections, Intra-Arterial; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
D007457:Iodine Radioisotopes; D004998:Ethiodized Oil
131I-labeled lipiodol; adjuvant therapy; hepatocellular carcinoma; recurrence; survival