Randomised trial of targeted chemotherapy with lipiodol and 5-epidoxorubicin compared with symptomatic treatment for hepatoma

Lipiodol injected into the hepatic artery isselectively retained in hepatomas so has beenused as a vehicle for cytotoxic drugs. Thisstudy compared treatment with 5-epidoxorubicinemulsified in lipiodol and infused intothe hepatic artery with symptomatic treatmentalone in a randomised trial. Of 136 patientswith hepatoma 78 (57%) were not elegible,eight (6%) refused to take part, and 50 enteredthe trial (chemotherapy: n=25, symptomatictreatment: n=25). The two groups had similarprognostic indices. Seven of 25 patientsallocated to chemotherapy were unable toreceive it. The slight survival disadvantageassociated with chemotherapy was not significant(median survival 48 days compared with51 days, log rank x2=0X07, p>0.05). Patientsgiven chemotherapy spent significantly longerin hospital, however (median three days comparedwith one, p=00008). Changes in symptomsand indices of tumour growth did notdiffer significantly between the two groups. Itis concluded that infusion of 5-epidoxorubicinemulsified in lipiodol for hepatoma increasedmorbidity but did not affect survival. In addition,most patients were unsuitable for thistreatment because of advanced disease. Thepatients in the trial had a short median survivaltime so the conclusions may not be valid forother patients with hepatoma.