Use of Lipiodol as a drug-delivery system for transcatheter arterial chemoembolization of hepatocellular carcinoma: a review

Crit Rev Oncol Hematol. 2013 Dec;88(3):530-49. doi: 10.1016/j.critrevonc.2013.07.003. Epub 2013 Aug 6.

Abstract

Hepatocellular carcinoma (HCC) remains a major public health problem. Transarterial chemoembolization (TACE) is recognized as the standard of care for patients with unresectable, asymptomatic, noninvasive and multinodular HCC. This procedure is based on percutaneous administration of a cytotoxic drug emulsified with Lipiodol followed by embolization of the tumour-feeding arteries. The standard procedure involves Lipiodol, an oily contrast medium which consists of a mixture of long-chain di-iodinated ethyl esters of poppy seed fatty acids. The aim of this review is to discuss the physical properties, tumour uptake behaviour and drug delivery effects of Lipiodol, the parameters influencing tumour uptake and future prospects. Lipiodol has a unique place in TACE as it combines three specific characteristics: drug delivery, transient and plastic embolization and radiopacity properties. Substantial heterogeneity in the physicochemical characteristics of Lipiodol/cytotoxic agent emulsions might reduce the efficacy of this procedure and justifies the current interest in Lipiodol for drug delivery.

Keywords: Cytotoxic drugs; Drug delivery; Hepatocellular carcinoma; Interventional radiology; Lipiodol; Theranostics; Transcatheter arterial chemoembolization.

Publication types

  • Review

MeSH terms

  • Animals
  • Antineoplastic Agents / administration & dosage*
  • Carcinoma, Hepatocellular / therapy*
  • Chemoembolization, Therapeutic* / adverse effects
  • Chemoembolization, Therapeutic* / methods
  • Combined Modality Therapy
  • Drug Delivery Systems*
  • Ethiodized Oil / administration & dosage*
  • Ethiodized Oil / adverse effects
  • Ethiodized Oil / pharmacokinetics
  • Humans
  • Liver Neoplasms / therapy*
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Ethiodized Oil