Tissue Distribution of Cisplatin After Hepatic Arterial Injection of a Cisplatin–Lipiodol Suspension Containing Phosphatidylcholine to Rabbits Carrying VX-2 Hepatic Carcinoma

Pharmaceutical Research -     

顺铂—碘油经肝动脉化疗栓塞肝细胞癌：药物动力学研究及临床疗效

对肝癌病人经肝动脉注射顺铂和碘油作化疗栓塞治疗，为了进行顺铂的药物动力学研究，将病人分为两组：A组，碘油和顺铂分开使用；B组，碘油和顺铂混合后使用，结果显示，与顺铂和碘油先后分开应用相比，采用顺铂－碘油混合剂可使顺铂选择性地滞留肿瘤组织中，并对抗癌药顺铂有明显地缓释作用，而且释放出来的铂主要以有活性的游离铂形式存在，此外，对16例肝癌患者化疗栓塞术后的疗效进行了评价，6例部分缓解（37．5％），10例稳定（62．5％），平均生存期8．5±3．4月，可以认为，顺铂碘油混合剂经肝动脉化疗栓塞治疗肝癌是一种安全，有效的方法。     

大剂量超液态碘油栓塞治疗巨块富血管型肝癌

目的:探讨大剂量碘油栓塞治疗巨块型富血管肝癌的疗效。方法:使用Seldinger穿刺方法,经股动脉置管行肝动脉栓塞化疗治疗巨块型富血管肝癌,一次超液态碘油剂量20～60mL。结果:98例患者接受大剂量超液态碘油栓塞化疗治疗,肝功能Child-Pugh A级者,肝功能损害不大,患者能耐受,与常规剂量栓塞组相比,无显著差别(P>0.05),其1～2、2～3、>3年生存率为77%、52.6％和18％,常规剂量栓塞治疗组为58.1％,32.5％和9％。大剂量超液态碘油栓塞较常规剂量栓塞治疗生存率高(P<0.05)。结论:大剂量碘油栓塞治疗巨块型富血管肝癌疗效较常规剂量栓塞治疗组好,其副作用无明显增加,该治疗方法可行。建议对肝功能 Child-Pugh A级者行大剂量超液态碘油栓塞治疗。     

原发性肝癌碘化油栓塞治疗后的CT诊断价值

目的 :探讨CT扫描在原发性肝癌导管化疗碘化油栓塞治疗疗效和预后的随访价值。材料与方法 :收集 82例原发性肝癌碘化油栓塞后各阶段CT扫描片 ,进行对比分析。结果 :有 4 9例 (5 9.7% )出现不同程度的沉积区碘化油丢失 ,出现肿瘤复发。另 33例未出现碘化油沉积的变化及肿瘤复发 ,生存时间明显延长 .结论 :CT扫描是原发性肝癌导管化疗伴碘化油栓塞治疗后观察疗效和预后的最直接 ,最有效的方法     

~(125)Ⅰ-LUF体毛导向治疗晚期肝癌初步报告

将标记放射性同位素~(125)I 的超液态碘化油(~(125)I-LUF)及自身体毛颗粒混入抗癌药,经导管超选择灌人供瘤动脉,治疗20例肝癌。在这种导向治疗前后分别作 CT、B 超、DSA 及 AFP 等对照检测及~(125)I 放射性测定。结果证明~(125)I 能牢固标记于 LUF,与体毛一起在100μm 直径以下的供瘤末梢动脉中长期滞留,不通过毛细血管进入全身循环,并能将抗瘤药限制在肿瘤局部发挥近距离长时间内照射化疗栓塞作用,对癌外正常组织损伤最小,术后副作用较轻,未发生排异反应,临床疗效满意。     

CT和肝区平片对肝癌碘油乳剂栓塞效果的观察

报告100例肝癌经肝动脉内注射碘油与抗癌药乳剂后2～4周和8～12周进行Lp-CT和肝区平片随访观察,按碘油沉积率和分布情况分五种类型。结果89例完全型者肿瘤缩小明显,其中35例获Ⅱ期手术切除,而其它类型者肿瘤无缩小。初步统计45例完全型者,一年以上生存率达69％。完全型疗效好,否则差,认为Lp-CT和肝区平片能较准确判断肝癌的栓塞效果,是选择Ⅱ期手术和提供复治时机具有重要意义的形态学依据。     

原发性肝癌肝动脉碘油抗癌药乳化剂栓塞后肝区平片的价值

作者对20例经肝动脉碘油抗癌药乳剂栓塞治疗的原发性肝癌，进行了栓后肝区平片碘油沉积形态与栓塞前DSA相应肿瘤染色的对照研究。将栓后碘油沉积形态分为三型：密整型、稀糙型和缺损型。结果说明：肝癌碘油栓后肝区平片能反映栓后肝癌的血供特点，栓后疗效和复发时间。而且简便，经济和有效。     

Cerebral lipiodol embolism following transcatheter arterial chemoembolization for hepatocellular carcinoma

Cerebral lipiodol embolism (CLE) is an extremely rare complication of transcatheter arterial chemoembolization for hepatocellular carcinoma (HCC). The authors present a case of CLE that occurred after the second hepatic arterial chemoembolization for HCC, and attempt to introduce several plausible mechanisms of CLE, after reporting the clinical and radiological findings and reviewing the medical literature.     

188Re-HDD/lipiodol therapy for hepatocellular carcinoma: an activity escalation study

Purpose The aim of this study was to investigate the feasibility of administering increasing activities of ¹⁸⁸Re-4-hexadecyl-1-2,9,9-tetramethyl-4,7-diaza-1,10-decanethiol/lipiodol (¹⁸⁸Re-HDD/lipiodol) for the treatment of hepatocellular carcinoma (HCC) in patients with well-compensated cirrhosis.Methods The activity levels were increased by 1.1 GBq/step after a 6-week interval without unacceptable adverse events in at least five consecutive patients. Absorbed doses to the various organs were calculated according to the MIRD formalism, based on three gamma-scintigraphic studies. Response was assessed by means of MRI and alpha-fetoprotein (AFP) monitoring.Results Thirty-five treatments were carried out in 28 patients. Activities from 4.8 to 7.0 GBq ¹⁸⁸Re-HDD/lipiodol were administered via a transfemoral catheter. The mean absorbed dose to the liver (including tumour) was 7.6±2.2, 9.8±4.9 and 15.2±4.9 Gy for the 4.8-, 5.9- and 7.0-GBq groups, respectively. Treatment was well tolerated at all activity levels. Further escalation of the administered activity was not feasible owing to limitations related to the radiolabelling procedure. Response assessment on MRI showed partial response, stable disease and disease progression in 1, 28 and 2 assessable treatments, respectively. In 8 of 17 treatment sessions with an initially elevated AFP, a reduction ranging from 19% to 97% was observed 6 weeks later.Conclusion Following the intra-arterial administration of 4.8–7.0 GBq ¹⁸⁸Re-HDD/lipiodol in patients with HCC and well-compensated liver cirrhosis, no severe adverse events occurred. Further escalation was not feasible owing to limitations in the radiolabelling procedure.     

Safety of using iodized oil in chemoembolization for liver tumors in patients with previous adverse reactions to iodinated contrast media

PurposeTo evaluate the safety of using iodized oil in chemoembolization for liver tumors in patients with previous adverse reactions to iodinated contrast media.Materials and methodsRecords were retrospectively reviewed for all patients with a history of an adverse reaction to iodinated contrast media who underwent angiography using gadolinium-based contrast media and/or carbon dioxide at our institution from January 1998 to September 2006. Patients who underwent chemoembolization or hepatic artery infusion for liver tumors using iodized oil were identified.ResultsThere were 84 procedures with use of iodized oil performed in 36 patients. Mild adverse reactions potentially related to iodized oil were seen in two procedures (2.4%). There were no moderate or severe adverse reactions (0.0%).ConclusionIodized oil can be safely used in patients with previous adverse reactions to iodinated contrast media.