Brief Article
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World J Gastroenterol. Dec 7, 2010; 16(45): 5766-5772
Published online Dec 7, 2010. doi: 10.3748/wjg.v16.i45.5766
Transarterial embolization ablation of hepatocellular carcinoma with a lipiodol-ethanol mixture
Yang-Kui Gu, Rong-Guang Luo, Jin-Hua Huang, Qi-Jiao Si Tu, Xiao-Xia Li, Fei Gao
Yang-Kui Gu, Jin-Hua Huang, Qi-Jiao Si Tu, Xiao-Xia Li, Fei Gao, State Key Laboratory of Oncology in Southern China, Department of Medical Imaging and Interventional Radiology, Cancer Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
Rong-Guang Luo, Department of Medical Imaging and Interventional Radiology, the First Affiliated Hospital of Nan-Chang University, 17 Yongwaizheng Street, Nanchang 330006, Jiangxi Province, China
Author contributions: Huang JH, Gu YK and Luo RG designed the research; Gu YK and Luo RG were responsible for reviewing the literature and the initial preparation of the manuscript; Luo RG, Si Tu QJ, Li XX and Gao F performed the research; Gu YK and Huang JH prepared the final version of the manuscript.
Correspondence to: Dr. Jin-Hua Huang, MD, Professor, State Key Laboratory of Oncology in Southern China, Department of Medical Imaging and Interventional Radiology, Cancer Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China. hjinh@mail.sysu.edu.cn
Telephone: +86-20-87343447 Fax: +86-20-87343272
Received: August 3, 2010
Revised: October 15, 2010
Accepted: October 22, 2010
Published online: December 7, 2010
Abstract

AIM: To determine the safety and effectiveness of transarterial embolization ablation (TEA) of hepatocellular carcinoma (HCC) with a lipiodol-ethanol mixture.

METHODS: Between January 1 and December 31, 2009, 15 patients with HCC (13 men/two women, aged 38-75 years) accepted TEA treatment and were enrolled in this study, including five newly diagnosed patients and 10 with refractory disease. Two months after TEA, angiography and contrast computed tomography (CT) were performed, and responses were assessed using a modified version of Response Evaluation Criteria in Solid Tumors (RECIST version 1.1). The follow-up period was to June 30, 2010.

RESULTS: Every new case was treated once. Angiography was performed immediately after TEA, and showed that the tumor-feeding vessels were completely embolized and that lipiodol was densely deposited inside tumors. Two months after treatment, contrast CT showed no enhanced lesions. Alpha fetoprotein levels returned to normal in four patients and markedly decreased in another. mean ± SD survival after treatment was 10.8 ± 4.5 mo. All five patients survived during the follow-up period. Ten patients with refractory disease were treated a total of 14 times. Angiography immediately after TEA showed that blood flow to the tumors was obviously decreased in all cases, and contrast CT showed obvious depositions of lipiodol. Two months after treatment, the tumors had shrunk (6/10) or were stable (3/10). One had progressed after 2 mo and died of tumor rupture 3 mo after TEA. mean ± SD survival after treatment was 8.6 ± 4.3 mo; two patients survived during the follow-up period. Adverse effects included reversible hepatic decompensation, upper abdominal pain, and fever.

CONCLUSION: TEA is an effective therapy for patients with HCC and might be more effective than transcather arterial chemoembolization for treating refractory disease.

Keywords: Transarterial embolization ablation; Lipiodol-ethanol mixture; Hepatocellular carcinoma