An preliminary experience with high doses of lipiodol in TACE for treating larger liver cancer

Objective To discuss the optimal lipiodol dosage, adverse effects and curative effect in lipiodol transcatheter arterial chemoembolization(Lp TACE) for larger hepatocellular carcinoma. Methods Total 300 patients were separated into 2 groups. In group 1 and 2 contained 240 and 60 cases with the tumor diameters 8～12cm and 13～18cm, and lipiodol dosage of 20～30ml and 25～60ml in Lp TACE, respectively. All of them had 12months or more follow up. Results The serum bilirubin level was mildly elevated in 283( 94.3% ) patients during 3～5days after Lp TACE. Seventeen(5.7%) cases(20ml lipiodol) had no obvious bilirubin elevation. The serum bilirubin level returned to normal for 90.5% patients during 1～2 weeks and 9.5% patients in one month. The body temperatures of patients were 37.5°C to 39.2°C(Centigrade) during 4～6 days after Lp TACE. The serum ALT level was increased continuously in 33 cases(11%) and a short term for the others. All patients had no severe complications. The cumulative survial rate were 89%(for 6 months) and 76% for one year. Conclusions Patients with proper indication could be undertaken for superselective Lp TACE full filled lipiodol accumulation in tumor. High dose lipiodol method is safe and ideal in TAE for larger HCC. Preventing lipiodol flow normal liver parenchyma or other organs will decrease adverse effects and protect liver function.