RANDOMIZED TRIAL OF TARGETED CHEMOTHERAPY WITH LIPIODOL AND 5-EPIDOXORUBICIN COMPARED WITH SYMPTOMATIC TREATMENT FOR HEPATOMA

Lipiodol injected into the hepatic artery is selectively retained in h epatomas so has been used as a vehicle for cytotoxic drugs. This study compared treatment with 5-epidoxorubicin emulsified in lipiodol and i nfused into the hepatic artery with symptomatic treatment alone in a r andomised trial. Of 136 patients with hepatoma 78 (57%) were not elegi ble, eight (6%) refused to take part, and 50 entered the trial (chemot herapy: n=25, symptomatic treatment: n=25). The two groups had similar prognostic indices. Seven of 25 patients allocated to chemotherapy we re unable to receive it. The slight survival disadvantage associated w ith chemotherapy was not significant (median survival 48 days compared with 51 days, log rank chi2 =0.07, p>0.05). Patients given chemothera py spent significantly longer in hospital, however (median three days compared with one, p=0.0008). Changes in symptoms and indices of tumou r growth did not differ significantly between the two groups. It is co ncluded that infusion of 5-epidoxorubicin emulsified in lipiodol for h epatoma increased morbidity but did not affect survival. In addition, most patients were unsuitable for this treatment because of advanced d isease. The patients in the trial had a short median survival time so the conclusions may not be valid for other patients with hepatoma.