CHEMOEMBOLIZATION OF HEPATOCELLULAR-CARCINOMA - CT FINDINGS AND CLINICAL-RESULTS IN PROSPECTIVE REPETITIVE THERAPY

Between April 1989 and March 1993 162 transarterial chemoembolisations (TACE) were performed repeatedly (mean interval: 2.9 months) in 52 patients with hepatocellular carcinoma (HCC). An emulsion of Lipiodol and epirubicine was injected as selectively as possible in a dosage proportional to liver function and tumour size. Before and after each TACE the size of tumours and ratio of tumour volume containing Lipiodol (RTVCL) were determined in CT and the grade of tumour vascularisation was assessed angiographically. The RTVCL increased from 58 % after the first treatment to 73 % after the third treatment. RTVCL and Lipiodol retention were higher in responders than in non-responders. Tumours with expansive growth pattern showed a higher response rate (56 %) than infiltrating tumours (20 %). Mean survival of these patients was different (19 and 8 months; p < 0.01), respectively. Survival rates of all patients were 54,22, and 11 % after 1, 2 and 3 years, respectively. Repeated TACE shows local effectiveness. Three treatments during a period of one year are recommended for patients with Child-Pug class A cirrhosis.