Segmental transarterial chemoembolization with lipiodol mixed with anticancer drugs for nonresectable hepatocellular carcinoma : follow-up CT and therapeutic results

• Published in: Cancer chemotherapy and pharmacology 1994-01, Vol.33 (S1), p.S60-S68
• Main Authors: NISHIMINE, K, UCHIDA, H, OHUE, S, FUKUI, H, TSUJII, T, MATSUO, N, SAKAGUCHI, H, HIROHASHI, S, NISHIMURA, Y, QIYONG GUO, OHISHI, H, NAGANO, N, YOSHIOKA, T
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; alpha-Fetoproteins - analysis; Antineoplastic agents; Antineoplastic Agents - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Biological and medical sciences; Carcinoma, Hepatocellular - diagnostic imaging; Carcinoma, Hepatocellular - therapy; Chemoembolization, Therapeutic; Chemotherapy; Cisplatin - administration & dosage; Doxorubicin - administration & dosage; Follow-Up Studies; Humans; Injections, Intra-Arterial; Iodized Oil - administration & dosage; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - therapy; Male; Medical sciences; Middle Aged; Mitomycin - administration & dosage; Neoplasm Recurrence, Local; Pharmacology. Drug treatments; Survival Rate; Tomography, X-Ray Computed
• ISSN: 0344-5704; 1432-0843
• DOI: 10.1007/BF00686670

We developed segmental Lp-TAE, which is transcatheter hepatic sub-subsegmental, subsegmental, or segmental chemoembolization using Lipiodol introduced into the tumor-bearing hepatic sub-subsegment, subsegment, or segment as the target area. A total of 98 patients with nonresectable hepatocellular carcinoma (HCC) undergoing segmental Lp-TAE (Seg-Lp-TAE) were studied, and the relationship between the CT pattern observed after Seg-Lp-TAE (Seg-Lp-CT) and the therapeutic results obtained in those patients was evaluated. Seg-Lp-CT was classified into four types (type I, homogeneous; type II, defective; type III, inhomogeneous; and type IV, only slight accumulation, if any) according to the Lipiodol accumulation pattern observed after Seg-Lp-TAE. The cumulative nonrecurrence rates of type I were higher than those of types II-IV. The cumulative survival rates of type Ia, in which Lp accumulation is also seen around the main tumor, were the highest (93.8% at 1 year, 85.9% at 2 years, 85.9% at 3 years, and 57.3% at 4 years). The cumulative survival rates achieved with Seg-Lp-TAE were 89.2% at 1 year, 69.4% at 2 years, 58.9% at 3 years, 44.0% at 4 years, and 30.2% at 5 years, which were higher than those achieved with conventional Lp-TAE. Seg-Lp-TAE is very useful in the treatment of HCC limited to one sub-subsegment, subsegment, or segment, and it is important to choose sub-subsegmental, subsegmental, or segmental Lp-TAE on the basis of the size and site of the tumor as well as the type and the number of feeding arteries.