RT Journal Article
SR Electronic
T1 Transarterial Injection of <sup>131</sup>I-Lipiodol, Compared with Chemoembolization, in the Treatment of Unresectable Hepatocellular Cancer
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 871
OP 877
DO 10.2967/jnumed.108.060558
VO 50
IS 6
A1 Laura Marelli
A1 Vibhakorn Shusang
A1 John R. Buscombe
A1 Evangelos Cholongitas
A1 Rosa Stigliano
A1 Neil Davies
A1 Jonathan Tibballs
A1 David Patch
A1 Tim Meyer
A1 Andrew K. Burroughs
YR 2009
UL http://jnm.snmjournals.org/content/50/6/871.abstract
AB Transarterial chemoembolization (TACE) improves survival in patients with hepatocellular carcinoma (HCC) in whom curative therapies are not suitable. The aim of this study was to assess survival differences in patients with hepatic cirrhosis and unresectable HCC treated by 131I-lipiodol versus TACE or transarterial embolization (TAE). Methods: A retrospective study was performed on a cohort of 124 patients undergoing treatment for unresectable HCC between 1997 and 2006. A total of 50 patients (44 men; mean age, 59 y) received 131I-lipiodol (mean sessions per patient, 1.7), and 74 patients (63 men; mean age, 61 y) received TACE/TAE (mean sessions per patient, 1.8). Although no significant difference between the 2 treatment groups with respect to HCC size and clinical staging was observed, a higher proportion of patients with portal vein thrombosis (PVT) was treated with 131I-lipiodol than with TACE/TAE (28% vs. 8%, P = 0.003). Results: Actuarial survival was not significantly different between patients treated with 131I-lipiodol and patients treated with TACE/TAE. Survival at 6 mo, 1 y, 2 y, and 3 y was 86%, 69%, 54%, and 45%, respectively, after 131I-lipiodol, compared with 77%, 62%, 47%, and 43%, respectively, after TACE/TAE. However, patients with PVT survived a mean of 454 d after 131I-lipiodol, compared with a mean of 171 d after TACE/TAE (P = 0.025). In addition, patients with more advanced disease (Barcelona Clinic Liver Cancer stage D) lived on average 363 d after 131I-lipiodol, compared with 36 d after TACE/TAE (P = 0.014). Conclusion: In patients with unresectable HCC, there was no difference in survival between 131I-lipiodol therapy and TACE/TAE treatment. However, in the patients with advanced clinical staging or PVT, there was a significant survival advantage for those treated with 131I-lipiodol.