[131-I-lipiodol in therapy of liver carcinoma--methods and case report]. / 131-J-lipiodol u lecenju karcinoma jetre--metodologija i prikaz slucaja.

INTRODUCTION: Primary malignant liver tumors are successfully treated only by means of surgery, but no more than 10% of patients are candidates for surgical intervention. The rest receive only palliative treatment which is, as a rule, unsuccessful. 131I-Lipiodol therapy (commercial label LIPIOCISTM) applied to the hepatic artery through a catheter has been used since 1984, primarily for treatment of hepatocellular carcinoma (HCC). The aim of this paper is to review the methodology of 131J-Lipiodol treatment of primary liver carcinomas. This treatment was applied for the first time in Yugoslavia. CASE REPORT: A female patient, 46 years of age had an inoperable primary liver carcinoma. Since progression of the disease couldn't be controlled by chemotherapy, treatment with 131I-Lipiodol was indicated. After blocking the thyroid with Lugol, Sol. 2.22 GBq of 131I-Lipiodol was injected into hepatic artery via catheter, and the patient was isolated in a designated facility until discharged. Around 5 months later, second therapeutic dose of 1.11 GBq was administered. Early post-therapy complications were severe, but transient. After 131I-Lipiodol therapy, the tumor growth was stopped, but the patient's general condition slowly deteriorated. The patient died 7 months after receiving the first therapeutic dose. CONCLUSION: In the reported patient, 131I-Lipiodol therapy stopped the tumor growth within the liver and significantly prolonged survival compared to the expected, but no improvement in quality of life was achieved. This treatment methodology is very complex. Medical staff providing care for these patients is exposed to substantial irradiation.

[Dosimetric measurements and early complications in patients with differentiated thyroid carcinomas treated with radioactive iodine]. / Dozimetrijska merenja i rane komplikacije kod bolesnika sa diferenciranim karcinomom stitaste zlezde lecenih radioaktivnim jodom.

The aim of the study was to determine the exposure dose rate during the application of radioiodine therapy (ablative or tumoral dose) given in order to treat the differentiated thyroid carcinoma, during the medical visit and examinations of those patients, to establish the safety distance from patients both for population and for medical staff and to perceive early complications after the therapy. The dosimetric measurements were performed in 10 patients. The exposure dose rate during the application of the therapy ranged from 2000 to 10000 pC/kg.s, during the visit from 528 to 15 pC/kg.s and during the examinations of patients from 5500 to 200 pC/kg.s. The average safety distance from patients for population was about 8.5 m on the day O (the very day of the therapy) and 2.0 m on the day 4, while for the medical staff it amounted to 5.0 m on the day 0 and 0.5 m on the day 4. The early complications perceived were as follows: radiation thyroiditis in 5/10 patients, stomach problems in 1/10 patients and transitorial leucopeny, forty days after the therapy, in 2/10 patients.