[Percutaneous hot ethanol injection therapy (PHEIT) for hepatocellular carcinoma]

Percutaneous ethanol injection therapy (PEIT) is widely performed as a local treatment for hepatocellular carcinoma (HCC). However, PEIT must be repeated because only a limited amount of ethanol can be injected in a single treatment. In addition, PEIT is only indicated for up to 3 tumors of 30 mm or less in diameter. We therefore invented a percutaneous hot ethanol injection therapy (PHEIT) to enhance the antitumor effect of PEIT. For this, we developed a liquid-heating and injection device to heat the liquid to the intended temperature and inject it from the tip of the needle safely and accurately using a puncture technique under ultrasonographic guidance. An experiment on normal rat livers demonstrated that injected ethanol at temperatures over 60 degrees C enhances the necrotizing effect on tissue. The technique was clinically applied to patients with HCC using ethanol heated to 60 degrees C or 70 degrees C. The total volume of the ethanol injection was smaller in PHEIT than in PEIT, and the frequency of injection was lower in PHEIT than in PEIT, while the necrotic area obtained by a single treatment was larger with PHEIT than with PEIT. PHEIT is a potential radical treatment for patients with multiple hepatoma with 4 more lesions or those with large hepatomas exceeding 30 mm in diameter that do not respond to PEIT.