Intraarterial HCC therapy with I-131-Lipiodol

We report on our 2-year experience with intraarterial fiver therapy with I- 131-Lipiodol in patients with hepatocellular carcinoma in Germany. 30 thera pies with intraarterial delivery of I-131-labeled Lipiodol were performed i n 14 patients with hepatocellular carcinoma (HCC) with or without portal ve in thrombosis during hepatic angiography. The patients were monitored for 1 ) distribution of Lipiodol by CT, 2) distribution of applied activity by pl anar scintigraphy and SPECT, and 3) tumor response by CT, MRT and 18-FDG-PE T. In 5 patients the tumor size was reduced after the first treatment (resp onder). Eight patients, primarily with big tumors (> 7 cm), had stable (4) or progressive disease (4), and 1 patient died because of renal failure. CT and SPECT showed pronounced I-131-lipiodol accumulation in the tumor tissu e in all patients with variable distribution patterns. One patient had an a cute pancreatitis like syndrome together with elevation of liver enzymes, p robably due to arterial spasm. 9 patients had transient and mild symptoms i n the upper abdomen, fever to 40 degrees C, and a leukocytosis. Two patient s had a transient mild elevation of pancreatic enzymes. All patients had a transient rise in liver enzymes. In conclusion therapeutic efficacy was dep endent on the tumor mass. Side effects due to the radiopharmaceutical were tolerable, and other side effects may result from the angiography procedure related manipulations. These results ave encouraging for tumors up to a mo derate mass.