Treatment of hepatocellular carcinoma by injection of iodine*131-labelled lipiodol into the hepatic artery.

ABSTRACT

The therapeutic efficacy iodine*131-labelled Lipiodol was studies in the treatment of hepatocellular carcinoma (HCC). The results of the treatment were evaluated for four aspects size of the tumour; serum alphafetoprotein level ; the quality of the patient’s life;and the survival rate. The hepatocellular carcinoma was diagnosed by evidence of mass in the liver using either computed tomography or ultrasonography with tissue biopsy and/or a high level of alphafetoprotein of more than 500 U. Twenty patients were randomized into two groups for comparison. The patients in group A were treated by intrahepatic injection of iodine*131-labelled Lipiodol 60 miliCuries(mCi). The patients in group B were treated by intra-hepatic injection of a mixture of Lipiodol and chemotherapeutic agents, mitomicin c 20 mg. and 5-fluoracil 500 mg., followed by selective hepatic artery embolisation of small pieces of gelatin sponge (gelfoam). Both groups were evaluated by computed tomography (CT) and the possible repeat of treatment protocol after two months. There were no serious side-effects or major complications in either group of patients. The patients’ conditions worsened by 40 percent in both groups. The tomours’ sizes remained unchanged by 50 percent in both groups. The serum alphafetoprotein levels had increased by 40 percent in group A, and remained unchanged by 50 percent in group B. The survival rates at one and two years in group A were 20 and 20 percent, and in group B there were 30 and 0 percent, respectively. Satisfactory results were obtained in the treatment of small HCC, size less than 5 cm. with intra-hepatic artery injection of iodine*131-labelled Lipiodol. In large HCC (>10cm) no response by the tumour was seen in either group. This was the first study of this type performed in Thailand.