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. 1993 Nov;34(11):1598–1600. doi: 10.1136/gut.34.11.1598

Randomised trial of targeted chemotherapy with lipiodol and 5-epidoxorubicin compared with symptomatic treatment for hepatoma.

M V Madden 1, J E Krige 1, S Bailey 1, S J Beningfield 1, C Geddes 1, I D Werner 1, J Terblanche 1
PMCID: PMC1374429  PMID: 8244149

Abstract

Lipiodol injected into the hepatic artery is selectively retained in hepatomas so has been used as a vehicle for cytotoxic drugs. This study compared treatment with 5-epidoxorubicin emulsified in lipiodol and infused into the hepatic artery with symptomatic treatment alone in a randomised trial. Of 136 patients with hepatoma 78 (57%) were not eligible, eight (6%) refused to take part, and 50 entered the trial (chemotherapy: n = 25, symptomatic treatment: n = 25). The two groups had similar prognostic indices. Seven of 25 patients allocated to chemotherapy were unable to receive it. The slight survival disadvantage associated with chemotherapy was not significant (median survival 48 days compared with 51 days, log rank chi 2 = 0.07, p > 0.05). Patients given chemotherapy spent significantly longer in hospital, however (median three days compared with one, p = 0.0008). Changes in symptoms and indices of tumour growth did not differ significantly between the two groups. It is concluded that infusion of 5-epidoxorubicin emulsified in lipiodol for hepatoma increased morbidity but did not affect survival. In addition, most patients were unsuitable for this treatment because of advanced disease. The patients in the trial had a short median survival time so the conclusions may not be valid for other patients with hepatoma.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Forbes A., Williams R. Chemotherapy and radiotherapy of malignant hepatic tumours. Baillieres Clin Gastroenterol. 1987 Jan;1(1):151–169. doi: 10.1016/0950-3528(87)90038-8. [DOI] [PubMed] [Google Scholar]
  2. Gail M., Gart J. J. The determination of sample sizes for use with the exact conditional test in 2 x 2 comparative trials. Biometrics. 1973 Sep;29(3):441–448. [PubMed] [Google Scholar]
  3. Kanematsu T., Furuta T., Takenaka K., Matsumata T., Yoshida Y., Nishizaki T., Hasuo K., Sugimachi K. A 5-year experience of lipiodolization: selective regional chemotherapy for 200 patients with hepatocellular carcinoma. Hepatology. 1989 Jul;10(1):98–102. doi: 10.1002/hep.1840100119. [DOI] [PubMed] [Google Scholar]
  4. Kanematsu T., Inokuchi K., Sugimachi K., Furuta T., Sonoda T., Tamura S., Hasuo K. Selective effects of Lipiodolized antitumor agents. J Surg Oncol. 1984 Mar;25(3):218–226. doi: 10.1002/jso.2930250317. [DOI] [PubMed] [Google Scholar]
  5. Kirk S., Blumgart R., Craig B., Rosen A., Terblanche J., Spence R. A. Irresectable hepatoma treated by intrahepatic iodized oil doxorubicin hydrochloride: initial results. Surgery. 1991 Jun;109(6):694–697. [PubMed] [Google Scholar]
  6. Lin D. Y., Liaw Y. F., Lee T. Y., Lai C. M. Hepatic arterial embolization in patients with unresectable hepatocellular carcinoma--a randomized controlled trial. Gastroenterology. 1988 Feb;94(2):453–456. doi: 10.1016/0016-5085(88)90436-2. [DOI] [PubMed] [Google Scholar]
  7. Nagasue N., Yukaya H., Hamada T., Hirose S., Kanashima R., Inokuchi K. The natural history of hepatocellular carcinoma. A study of 100 untreated cases. Cancer. 1984 Oct 1;54(7):1461–1465. doi: 10.1002/1097-0142(19841001)54:7<1461::aid-cncr2820540740>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  8. Okuda K. Diagnosis and nonsurgical treatment of hepatocellular carcinoma. Hepatogastroenterology. 1990 Apr;37(2):159–164. [PubMed] [Google Scholar]
  9. Okuda K., Ohtsuki T., Obata H., Tomimatsu M., Okazaki N., Hasegawa H., Nakajima Y., Ohnishi K. Natural history of hepatocellular carcinoma and prognosis in relation to treatment. Study of 850 patients. Cancer. 1985 Aug 15;56(4):918–928. doi: 10.1002/1097-0142(19850815)56:4<918::aid-cncr2820560437>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
  10. Pelletier G., Roche A., Ink O., Anciaux M. L., Derhy S., Rougier P., Lenoir C., Attali P., Etienne J. P. A randomized trial of hepatic arterial chemoembolization in patients with unresectable hepatocellular carcinoma. J Hepatol. 1990 Sep;11(2):181–184. doi: 10.1016/0168-8278(90)90110-d. [DOI] [PubMed] [Google Scholar]
  11. Smith A. H., Bates M. N. Confidence limit analyses should replace power calculations in the interpretation of epidemiologic studies. Epidemiology. 1992 Sep;3(5):449–452. doi: 10.1097/00001648-199209000-00011. [DOI] [PubMed] [Google Scholar]
  12. Wands J. R., Blum H. E. Primary hepatocellular carcinoma. N Engl J Med. 1991 Sep 5;325(10):729–731. doi: 10.1056/NEJM199109053251010. [DOI] [PubMed] [Google Scholar]

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