[Therapy of hepatic carcinoma by the intra-arterial injection of lipiodol, antineoplastic agents and gelfoam].

Chemoembolization by selective intra-arterial injection of lipiodol--chemotherapeutic agents (mitomycin and/or adriamycin)--followed by terminal embolization with gelfoam was performed on 20 inoperable patients with hepatic tumors: 13 hepatocellular carcinomas (HCC), 6 metastases from colorectal cancer, and one adenoma. A total of 29 embolizations were performed, 17 of them followed by gelfoam embolization. Significant decrease in tumor size or no tumor increase was shown in 8 patients--6 capsulated and well-limited HCC's, and 2 multinodular HCC's. Apart from occasional episodes of post-embolization syndrome (fever, vomit, abdominal pain), no significant complications were observed. Nine patients died at intervals ranging from 2 weeks to 37 months after the first embolization; in 6 patients the cause of death was not related to the advancing of the cancer, but to the complications of the underlying cirrhosis. In cirrhotic patients, damage to the rest of liver parenchyma can be limited by using superselective catheterization. Of the 6 patients with greater than 12 months follow-up, 4 are alive and 2 have died; 2 more patients are still alive 18 months after the first embolization. Finally, lipiodol was useful as radiopaque marker to detect lesion changes during the follow-up.