title: Combination therapy of percutaneous ethanol injection and radiofrequency ablation against hepatocellular carcinomas difficult to treat.
abstract: Radiofrequency ablation (RFA) is an effective modality for the treatment of hepatocellular carcinoma (HCC), because it can induce large coagulated necrosis in a few sessions. We have recently reported that the combination therapy of percutaneous ethanol injection (PEI) with RFA (PEI-RFA) created enhancement of coagulated necrosis compared with RFA alone. In the present study, we adopted PEI-RFA for the treatment of HCCs located in the regions that are difficult to treat with RFA alone. Five patients with biopsy-proven HCC and liver cirrhosis underwent PEI-RFA therapy. In these patients, HCCs were located beside the gallbladder, inferior vena cava or portal vein or kidney, or immediately under the diaphragm. Prior to RFA, 99.5% ethanol was injected into the region of HCC located in the regions where RFA energy appears to be difficult to reach. In all cases, HCC was totally coagulated by PEI-RFA. Injecting ethanol prior to RFA therapy caused no major side effects. These results indicate that PEI-RFA may be effective for the treatment of HCCs located in the regions that are difficult to treat with RFA alone as well as large-sized HCCs.
authors.affiliation: Third Department of Internal Medicine, Kagawa Medical University, 1750-1 Ikenobe, Miki-cho, Kagawa 761-0793, Japan.
authors.forename: Kazutataka
authors.initials: K
authors.lastname: Kurokohchi
authors.forename: Seishiro
authors.initials: S
authors.lastname: Watanabe
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Masaki
authors.forename: Naoki
authors.initials: N
authors.lastname: Hosomi
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Funaki
authors.forename: Keiji
authors.initials: K
authors.lastname: Arima
authors.forename: Shuhei
authors.initials: S
authors.lastname: Yoshida
authors.forename: Seiji
authors.initials: S
authors.lastname: Nakai
authors.forename: Masayuki
authors.initials: M
authors.lastname: Murota
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Miyauchi
authors.forename: Shigeki
authors.initials: S
authors.lastname: Kuriyama
mesh_terms: D000279:Administration, Cutaneous; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods; D003131:Combined Modality Therapy; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D008297:Male
chemical_list: D000431:Ethanol