title: Transarterial Alcohol-Lipiodol Therapy in Patients with Hepatocellular Carcinoma Using Low Alcohol Concentrations.
abstract: OBJECTIVE
  To evaluate transarterial alcohol-lipiodol therapy (TAL) with low concentrations of alcohol for the treatment of hepatocellular carcinoma (HCC).
  
  
  METHODS
  17 patients (69.3 ± 10.7a, 13 male, 4 female) with previously untreated HCC (tumor diameter: 7.7 ± 5.8 cm), who underwent 20 transarterial alcohol-lipiodol injections, were evaluated retrospectively. 14 patients had HCC with coexistent cirrhosis (Child-A n = 9, Child-B n = 4, Child-C n = 1). 9 patients presented an Okuda stage I, 7 patients an Okuda stage II and 1 patient an Okuda stage III. Infiltration of the portal vein was seen in 3 patients.
  
  
  RESULTS
  15 patients underwent TAL with an alcohol:lipiodol ratio of 1:2, another one with a ratio of 1:3 and yet another one with a ratio of 1:5. The median survival was 23 months, and the 1-year and 2-year survival rates were 62.7 % and 31.4 %, respectively. The median survival of patients with HCC < 7.5 cm (n = 10) was 25 months and significantly (p = 0.009) higher than for patients with HCC ≥ 7.5 cm (n = 7; 3 months). Tumor diameters ≥ 7.5 cm were associated with worse lipiodol-contrasting of HCC. Intrainterventional side effects were only feelings of slight abdominal pressure in 2 of 20 interventions. Postinterventional, mild side effects were observed after 3 interventions (abdominal pain n = 1, thoracic pain n = 1, fever n = 1). Serious complications were not observed, in particular there was no decompensation of liver cirrhosis.
  
  
  CONCLUSIONS
  TAL with low concentrations of alcohol was a safe and effective treatment in our cohort in spite of extensive tumors and impaired liver function. TAL could be a treatment option for patients who cannot receive other therapies (e. g. TACE, RFA) because of their advanced tumor disease, liver cirrhosis or other contraindications.
  
  
  CONCLUSIONS
  • TAL can be performed safely in advanced tumor disease and liver cirrhosis Citation Format: • Mohné F, Meyer C, Kuhl CK et al. Transarterial Alcohol-Lipiodol Therapy in Patients with Hepatocellular Carcinoma Using Low Alcohol Concentrations. Fortschr Röntgenstr 2016; 188: 676 - 683.
authors.affiliation: Department of Radiology, University Hospital Bonn, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Mohné
authors.affiliation: Department of Radiology, University Hospital Bonn, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Meyer
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Germany.
authors.forename: C K
authors.initials: CK
authors.lastname: Kuhl
authors.affiliation: Department of Radiology, University Hospital Bonn, Germany.
authors.forename: C C
authors.initials: CC
authors.lastname: Pieper
authors.affiliation: Department of Radiology, University Hospital Bonn, Germany.
authors.forename: H H
authors.initials: HH
authors.lastname: Schild
mesh_terms: D055011:Ablation Techniques / Q000379:methods*; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination / Q000379:methods; D000431:Ethanol / Q000008:administration & dosage*; D004998:Ethiodized Oil / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007269:Injections, Intra-Arterial; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D000431:Ethanol; D004998:Ethiodized Oil