Patients with inoperable liver cancer rely on treatments outside of surgery for cure or control of symptoms of their disease. Many new and innovative therapies are being studied in hopes of improving survival rates or survival time for patients whose cancer is too advanced to consider surgery a viable option. A study in Germany using radioactive isotopes directed specifically at the cancer produced encouraging results for people with primary, inoperable liver cancer of moderate size.
Primary liver cancer, sometimes called hepatocellular cancer or cholangiocarcinoma, is characterized by cancer that starts in cells of the liver and can spread, through blood vessels, to different parts of the body. Commonly, people with liver cancer already suffer from cirrhosis of the liver or viral hepatitis, both damaging diseases to the liver making treatment even more difficult. The liver is the largest organ in the body and is responsible for over 500 functions, including the secretion of glucose, proteins, vitamins and fats, the production of bile, the processing of hemoglobin and the detoxification of numerous substances. The treatment of liver cancer depends on the size and specific stage (extent of disease in the body) of the cancer. Only a small percentage of patients are eligible for surgical resection (removal of the cancer) because their cancer is small and localized. The majority of patients, however, have cancer that has replaced too much of the liver or spread outside the liver to other parts of the body, and surgery is not a viable option.
The use of I-131-Lipidiol is now being studied as an option for treatment of people with inoperable liver cancer. I-131 is a radioactive substance that is linked to Lipidiol, an innocuous liquid that is readily taken up by cancer cells. I-131, a radioactive isotope, is a type of substance that spontaneously emits forms of radiation. When Lipidiol is taken up by the cancer cells, the attached I-131 kills these cancer cells by emission of it’s radiation.
In Germany, 14 patients with inoperable, primary liver (hepatocellular) cancer underwent intra-arterial infusion of I-131-Lipidiol. First, an angiogram (x-ray of blood vessels) was performed in order to locate the artery used to supply blood and Oxygen to the cancer cells. A catheter was placed in this artery and I-131-Lipidiol was infused through the catheter. Five patients showed a reduction in their cancer and 4 patients with large cancers stabilized with no further growth of the cancer. Four patients had progression of their cancer and 1 died from complications from the procedure.
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Because liver cancer is such a difficult cancer to cure without surgical resection, physicians conducting this study concluded that intra-arterial infusion of I-131-Lipidiol is a useful treatment in patients with inoperable liver cancer of moderate size. According to this study, the efficacy of this treatment depends on the size of the cancer, with tumors less than 3 inches in diameter responding optimally. Persons who have liver cancer with may wish to talk with their doctor about the risks and benefits of this treatment or participation in a clinical trial utilizing this or other promising therapies.
(Cancer Biotherapy and Radiopharmacy, Vol 15, No 1, pp 65-70, 2000).