平田 真美¹, 西村 庸夫²

Mami HlRATA¹, Nobuo NlSHIMURA²

¹松山城東病院内科, ²松山市民病院内科

¹Department of Internal Medicine, Matsuyama Joutou Hospital, ²Department of Internal Medicine, Matusyama Shimin Hospital

キーワード : Hepatocellular carcinoma , Percutaneous ethanol injection therapy , Ultrasound guidance

Percutaneous ethanol injection therapy (PEIT) has recently been used alone to treat hepatocellular carcinomas 2 cm or less in diameter, and has become the first choice for mecidical treatment. In cases involving tumors measuring 3 cm or more in diameter, however, or in patients with three or more tumor nodules, treatment with PEIT alone is less effective; in these cases a combination of multiple treatments and arterial embolism may be warranted. Although PEIT has only local antitumor effects, complete tumor necrosis may be achieved when PEIT is performed accurately. When we used PEIT alone to treat both patients with hepatocellular carcinomas measuring 3 cm or more in diameter and those with multiple nodules, local treatment effect was almost equal to that obtained in cases of small hepatocellular carcinomas. Although larger doses of ethanol were used to treat larger tumors and larger numbers of nodules, severe side effects and complications were avoided because of the method used to inject the ethanol. To expand the indications for PEIT, it was considered necessary to prevent reflux or leakage of ethanol, to increase the effective dose reaching the tumor, and to induce sufficient diffusion within the tumor.