Survival after 131I-labeled lipiodol therapy for hepatocellular carcinoma. A single-center study based on a long-term follow-up.

Abstract

UNLABELLED:

This study investigated the efficacy of 131iodine-labeled lipiodol (131I-lipiodol) as a palliative therapy, evaluated overall survival (OS) across Barcelona Clinic Liver Cancer (BCLC) stages, and determined the main prognostic factors influencing OS in patients with hepatocellular carcinoma (HCC).

PATIENTS, METHODS:

We retrospectively analyzed 57 (44 men; mean age, 65.7 years; mean activity per session, 1.6 GBq; mean cumulative activity in patients with >1 sessions, 3.9 GBq) HCC patients who underwent 131I-lipiodol therapy. A majority of patients exhibited Child-Pugh class B (53.6%) disease and a good Eastern Cooperative Oncology Group performance status (0-1; 72%). Multinodular disease was observed in 87.7% patients, bilobar disease in 73%, and portal vein occlusion (PVO) in 54%. Furthermore, 21.1% patients were staged as BCLC B and 59.6 % as BCLC C. All patients were followed until death.

RESULTS:

The median OS was 6.4 months, which varied significantly with disease stage (median OS for BCLC A, B, C, and D was 29.4, 12.0, 4.6, and 2.7 months, respectively; p = 0.009); Child-Pugh score and class; presence of ascites, PVO, or extrahepatic disease; largest lesion size; favourable treatment response; international normalized ratio, baseline albumin and alpha-fetoprotein levels. Patients with a Child-Pugh A liver disease had a longer OS.

CONCLUSION:

Currently, different treatment modalities for HCC include radioembolization, transarterial chemoembolization, and systemic therapy with sorafenib; however, 131I-lipiodol therapy remains a feasible alternative for patients without a favourable response to other therapies, particularly for patients with Child-Pugh A liver cirrhosis.

• Authors: H Ahmadzadehfar, E Habibi, S Ezziddin, K Wilhelm, R Fimmers, U Spengler, H Palmedo, H Strunk, H H Schild, H J Biersack, J Risse
• Journal: Nuklearmedizin. Nuclear medicine (Nuklearmedizin) Vol. 53 Issue 2 Pg. 46-53 ( 2014) ISSN: 2567-6407 [Electronic] Germany
• PMID: 24468919 (Publication Type: Journal Article)

Chemical References

• Radiopharmaceuticals
• Ethiodized Oil

Topics

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Hepatocellular (diagnostic imaging, radiotherapy)
• Chemoradiotherapy
• Ethiodized Oil (therapeutic use)
• Female
• Follow-Up Studies
• Humans
• Liver Neoplasms (diagnostic imaging, radiotherapy)
• Longitudinal Studies
• Male
• Middle Aged
• Radionuclide Imaging
• Radiopharmaceuticals (therapeutic use)
• Retrospective Studies
• Survival Rate
• Treatment Outcome