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131Iodine-DEM TACE vs. conventional TACE in cirrhotic patients with hepatocellular carcinoma: a single center experiment.

Background
To evaluate the safety and efficacy of transcatheter arterial chemoembolization (TACE) with 131iodine-doxorubicin-eluting gelatin microspheres (131I-DEM TACE) compared with conventional TACE (cTACE) with polyvinyl alcohol foam (PVA) embolization microspheres.


Methods
A total of 22 patients diagnosed with hepatocellular carcinoma were equally divided into 2 groups. The patients who underwent TACE with 131I-DEM (25.7×107 Bq of 131iodine and 10 mg of doxorubicin) were compared to controls who received cTACE with PVA embolization microspheres. Therapeutic effects were evaluated by the tumor regression rates, levels of alpha-fetoprotein in serum, survival rates, and complications.


Results
The operative complications of the 2 groups were not significantly different (P=0.753). The radioactivity ratio of the tumor to the liver was approximately 4.1:1 for the 131I-DEM TACE group. In the 131I-DEM TACE group, 54.5% of patients achieved tumor regression of more than 50%, compared to 36.6% of patients in the cTACE group. AFP levels in serum declined in 100% of patients in the 131I-DEM TACE group and 50% of patients in the cTACE group. The median survival time of the patients was 12.0±3.3 months for the 131I-DEM TACE group and 10.0±3.3 months for the cTACE group. There were no significant differences in survival between the 2 groups (P=0.414).


Conclusions
131I-DEM may become a potential radiochemoembolization agent to treat patients with unresectable hepatocellular carcinoma through TACE.