Nodular hepatocellular carcinoma. Treatment with subsegmental intraarterial injection of iodine 131‐labeled iodized oil

Internal radiation therapy with subsegmental arterial injection of iodine 131(131I)‐labeled iodized oil (Lipiodol; Laboratorie, Guerbet, France) was evaluated in 24 patients with nodular hepatocellular carcinoma (HCC) ranging from 2.5 to 8.0 cm in size. 131I Lipiodol (555 to 2220 MBq in 3 to 8 ml) was injected depending on the tumor size. Tumor reduction was seen in 88.9% of tumors smaller than 4.0 cm in diameter, 65.5% of tumors between 4.1 to 6.0 cm, and 25.0% of tumors larger than 5.1 cm. The tumor size reduction corresponded to the gradual drop of serum alphafetoprotein (AFP) levels and devascularization on follow‐up angiography. Adverse reactions from treatment included fever, mild abdominal pain, nausea, and elevation of transaminases. These were mild and well tolerated by patients. This method provided long‐term local control without complications related to the thyroid, lung, gastrointestinal tract, and bone marrow.