Hepatocellular carcinoma: treatment with intraarterial iodized oil with and without chemotherapeutic agents.

Abstract

Thirty-one patients with hepatocellular carcinoma (HCC) were given either an intraarterial injection of iodized poppyseed oil (Lipiodol) alone (group A, n = 6), an emulsion of iodized oil and doxorubicin hydrochloride (Adriamycin) (group B, n = 15), or chemoembolization with the same emulsion followed by gelatin sponge (Gelfoam) particles (group C, n = 10). Hepatic resection was subsequently performed. The frequencies of complete necrosis of tumor in the main lesion, daughter tumors, tumor thrombus, and foci of intracapsular invasion were evaluated in the cut surface of the resected specimen. Group C demonstrated the best therapeutic effects, showing complete necrosis of the main lesion in 83% (P less than .01), daughter tumors in 53% (P less than .01), tumor thrombus in 17%, and foci of intracapsular invasion in 67%. These results are superior to those reported previously for chemoembolization without iodized oil. Group B showed better results than group A, but the difference was not significant. Iodized oil alone (group A) had practically no therapeutic effect but was helpful in differentiating small HCC from regenerative nodules.

Transcatheter Arterial Chemo-Embolization with a Fine-Powder Formulation of Cisplatin for Unresectable Hepatocellular Carcinoma

“…8,9 The most commonly used agent in TACE for HCC treatment is an emulsion of LPD and ADM, followed by embolization with gelatin sponge particles, 10,11 but tumors frequently recur 9,12,13 or residual tumors are observed at a high rate. CDDP is an effective anticancer agent used in the treatment of various malignancies.…”

“…10,11 However, the tumors have been demonstrated to show a high frequency of recurrence after TACE. 9,12,13 Cisplatin (CDDP), a platinum compound, is an effective anticancer agent used in the treatment of various malignancies. 14 Researchers have recently reported that TACE using a suspension of CDDP in LPD may be more effective against unresectable HCC than that using ADM-LPD emulsion.…”

Radiofrequency ablation combined with transcatheter arterial embolisation in rabbit liver: investigation of the ablation zone according to the time interval between the two therapies

“…The animals were maintained in a room with a constant temperature (23¡2 u C) and a 12-h light/dark cycle, and were given access to a standard diet and water. During all procedures, the animals were anaesthetised with an intramuscular injection of 5 mg kg 21 body weight tiletamine-zolazepam (Zoletil 50; Virbac, Carros, France) and 2 mg kg 21 body weight 2% xylazine hydrochloride (Rompun; Bayer, Seoul, South Korea). Animals were randomly divided into three groups of five each: Group A was treated with RFA alone, Group B was treated with the single-session of combined therapy (TAE immediately followed by RFA on the same day) and Group C was treated with the dual-session combined therapy (TAE followed by RFA 5 days later; Figure 1).…”

Chemoembolization in the Management of Liver Tumors

“…There are multiple variations on the technique and ingredients, but it has evolved into a common procedure in many institutions worldwide to palliate patients with previously untreatable malignancies. Early studies demonstrated that extensive tumor necrosis could be produced, with radiographic tumor response rates of up to 83% [26][27][28][29][30][31]. Tissue levels of chemotherapy were found to be up to 40 times higher in the tumor than in the surrounding liver, and to persist for several months [32][33][34][35].…”