Kurokohchi Kazutaka, Masaki Tsutomu, Miyauchi Yoshiaki, Funaki Toshiharu, Yoneyama Hirohito, Miyoshi Hisaaki, Yoshida Shuhei, Himoto Takashi, Morishita Asahiro, Uchida Naohito, Watanabe Seishiro, Kuriyama Shigeki
Third Department of Internal Medicine, Kagawa University School of Medicine, Miki-cho, Kita-gun, Kagawa 761-0793, Japan.
Int J Oncol. 2004 Feb;24(2):381-7.
Radiofrequency ablation (RFA) therapy is of great significance in the treatment of hepatocellular carcinoma (HCC) or metastatic liver tumors. RFA is able to achieve widely coagulated necrosis in a few sessions without major complications. However, HCC cases exist that are resistant to RFA therapy for several reasons. In the present study, we performed injection of the mixture of ethanol and lipiodol (percutaneous ethanol-lipiodol injection therapy: PELIT) for HCCs that lacked clear visuality of the entire shape of the tumor by ultrasonography (US) or computed tomography (CT), or that were difficult to treat with RFA alone due to their locations in the liver or due to severe liver dysfunction of the patients. Local recurrence rates of HCC treated with PELIT were shown to be low in patients followed up for at least 4 months. In all patients treated with PELIT, lipiodol was accumulated in the entire region of the tumor after several trials of PELIT and the accumulation was kept for many months. The biopsy examination from the tumor treated with PELIT showed that HCC cells were totally destroyed by the PELIT. Although RFA therapy serves as a central role for the treatment of HCCs, PELIT, considered to be milder therapy, is likely to be important as a supportive treatment for HCCs and useful for the treatment of HCCs that are difficult to treat with RFA.
射频消融（RFA）治疗在肝细胞癌（HCC）或转移性肝肿瘤的治疗中具有重要意义。RFA能够在几次治疗中实现广泛的凝固性坏死，且无重大并发症。然而，由于多种原因，存在对RFA治疗耐药的HCC病例。在本研究中，对于那些通过超声（US）或计算机断层扫描（CT）无法清晰显示肿瘤整体形状，或者由于其在肝脏中的位置或患者严重肝功能障碍而难以单独用RFA治疗的HCC，我们进行了乙醇与碘油混合注射（经皮乙醇-碘油注射治疗：PELIT）。在至少随访4个月的患者中，PELIT治疗的HCC局部复发率较低。在所有接受PELIT治疗的患者中，经过多次PELIT治疗后，碘油在肿瘤的整个区域积聚，且这种积聚持续了数月。对接受PELIT治疗的肿瘤进行活检检查显示，HCC细胞被PELIT完全破坏。尽管RFA治疗在HCC治疗中起核心作用，但被认为是较温和治疗的PELIT，作为HCC的支持性治疗可能很重要，并且对难以用RFA治疗的HCC治疗有用。
