Park J H, Kim S H, Han J K, Chung J W, Han M C
Department of Diagnostic Radiology, Seoul National University College of Medicine, Korea.
Cardiovasc Intervent Radiol. 1994 Nov-Dec;17(6):323-7. doi: 10.1007/BF00203951.
The effectiveness of renal transcatheter arterial embolization (TAE) with a mixture of ethanol and iodized oil (Lipiodol) was analyzed retrospectively in 27 patients with unresectable renal cell carcinoma.
Symptomatic or permanent palliation by TAE was performed with the intent to achieve total or partial ablation of the kidney with 10-28 ml of embolic material in a 3:1 mixture of ethanol and iodized oil. Clinical, angiographic, and computed tomographic (CT) follow-up were analyzed. Cumulative survival was estimated with the Kaplan-Meier method.
Partial (5) or complete (22) ablation of the embolized kidneys was achieved in all cases. Follow-up CT after 1 month revealed Lipiodol uptake in the tumor area (14/14), decreased size of the tumor (6/14), and gas formation (7/14). Pulmonary metastasis improved significantly in one patient after transcatheter arterial embolization and adjunctive chemotherapy. Overall median survival of the 27 patients was 8.5 months. The median survival was 23 months in 10 patients with stage III, three of whom are still alive, and was 7 months in 15 patients with stage IV tumors.
The mixture of ethanol and Lipiodol is not only a convenient embolic material to use, but is also effective for selective or nonselective devascularization for unresectable renal cell carcinoma.
回顾性分析27例不可切除肾细胞癌患者采用乙醇与碘化油（碘油）混合剂进行肾动脉导管栓塞术（TAE）的有效性。
采用TAE进行症状性或永久性姑息治疗，旨在用10 - 28毫升栓塞材料（乙醇与碘油按3:1混合）实现肾脏全部或部分消融。分析临床、血管造影和计算机断层扫描（CT）随访情况。采用Kaplan-Meier法估计累积生存率。
所有病例均实现了栓塞肾脏的部分（5例）或完全（22例）消融。1个月后随访CT显示肿瘤区域有碘油摄取（14/14）、肿瘤大小减小（6/14）和气体形成（7/14）。1例患者经导管动脉栓塞术及辅助化疗后肺转移明显改善。27例患者的总体中位生存期为8.5个月。10例Ⅲ期患者的中位生存期为23个月，其中3例仍存活；15例Ⅳ期肿瘤患者的中位生存期为7个月。
乙醇与碘油的混合剂不仅是一种方便使用的栓塞材料，而且对不可切除肾细胞癌的选择性或非选择性血管去功能化有效。
