RESUMEN
PURPOSE: To evaluate transarterial alcohol-lipiodol therapy (TAL) with low concentrations of alcohol for the treatment of hepatocellular carcinoma (HCC). MATERIALS AND METHODS: 17 patients (69.3â±â10.7a, 13 male, 4 female) with previously untreated HCC (tumor diameter: 7.7â±â5.8âcm), who underwent 20 transarterial alcohol-lipiodol injections, were evaluated retrospectively. 14 patients had HCC with coexistent cirrhosis (Child-A nâ=â9, Child-B nâ=â4, Child-C nâ=â1). 9 patients presented an Okuda stage I, 7 patients an Okuda stage II and 1 patient an Okuda stage III. Infiltration of the portal vein was seen in 3 patients. RESULTS: 15 patients underwent TAL with an alcohol:lipiodol ratio of 1:2, another one with a ratio of 1:3 and yet another one with a ratio of 1:5. The median survival was 23 months, and the 1-year and 2-year survival rates were 62.7â% and 31.4â%, respectively. The median survival of patients with HCC <â7.5âcm (nâ=â10) was 25 months and significantly (pâ=â0.009) higher than for patients with HCC ≥â7.5âcm (nâ=â7; 3 months). Tumor diameters ≥â7.5âcm were associated with worse lipiodol-contrasting of HCC. Intrainterventional side effects were only feelings of slight abdominal pressure in 2 of 20 interventions. Postinterventional, mild side effects were observed after 3 interventions (abdominal pain nâ=â1, thoracic pain nâ=â1, fever nâ=â1). Serious complications were not observed, in particular there was no decompensation of liver cirrhosis. CONCLUSION: TAL with low concentrations of alcohol was a safe and effective treatment in our cohort in spite of extensive tumors and impaired liver function. TAL could be a treatment option for patients who cannot receive other therapies (e.âg. TACE, RFA) because of their advanced tumor disease, liver cirrhosis or other contraindications. KEY POINTS: â¢âTAL can be performed safely in advanced tumor disease and liver cirrhosis Citation Format: â¢âMohné F, Meyer C, Kuhl CK etâal. Transarterial Alcohol-Lipiodol Therapy in Patients with Hepatocellular Carcinoma Using Low Alcohol Concentrations. Fortschr Röntgenstr 2016; 188: 676â-â683.