Treatment of liver metastases with intra arterial Lipiodol - Adriamycin

Selective intra arterial administration of cytotoxics in Lipiodol (Lipiodolisation) is an accepted treatment for hepatocellular carcinoma but there is also now some encouraging evidence of activity in liver metastases. We treated 17 heavily pretreated patients with liver metastases with Lipiodol and Adriamycin and investigated the role of dose escalation by treating 10 patients with Adriamycin (40 mg) and seven further patients with Adriamycin (80 mg). Lipiodol uptake showed good specificity for tumour on post lipiodol Computerised Tomographic (CT) scanning. There were marker responses in 5/11 patients with elevated markers. There were however no significant CT responses. Dose escalation was associated with greater systemic toxicity. Lipiodol - Adriamycin is effective at delivering chemotherapy to liver metastases and is associated with evidence of response even in heavily pretreated patients.