Background: The single-arm study of transcatheter arterial chemoembolization (TACE) for unresectable hepatocellular carcinoma (HCC) between Korea and Japan showed a markedly favorable efficacy with mild toxicity, and its results will be regarded as valuable data to obtain regulatory approval for this treatment modality. However, the details of the technique to prepare epirubicin-lipiodol emulsion have not been clarified. Therefore, we conducted an additional survey of the technique in the Japanese institutions participating in the cooperative study.
Method: The following items were included in the questionnaire sent to the 19 institutions.
1) Number of patients enrolled in the Korea-Japan cooperative study.
2) Whether preparation of epirubicin-lipiodol emulsion is changed in individual cases or not.
3) Detailed technique to prepare epirubicin-lipiodol emulsion
4) The volume ratio of lipiodol and the emulsion for mixture
Results: Seventy-five patients were enrolled from 19 institutions. In each institution, the technique to prepare epirubicin-lipiodol emulsion was standardized. Although there were slight differences in individual institutions, in most the emulsion consisted of a small volume of epirubicin solution and contrast medium mixed with lipiodol in a 1:1 to 1:2 ratio.
Conclusion: Techniques to prepare epirubicin-lipiodol emulsion are largely standardized, and the minimal differences are recognized in the allowable range considering the favorable efficacy and mild toxicity shown by the Korea-Japan cooperative study.
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