[Intra-tumoral injection therapy in patients with hepatocellular carcinoma]

Ten patients with hepatocellular carcinoma (HCC) received intra-tumoral injection of OK-432 (6 patients), 99.5% ethanol (2 patients) or both (2 patients). Under ultrasonographic control, a PTC needle (22 G) was inserted percutaneously into the tumor and OK-432, which was prepared with a solution of Su-strain Streptococcus pyogenes A3, or 99.5% ethanol was injected. Patients were injected with OK-432 repeatedly at one-to two-week intervals (up to 5 times) for a total duration of 5 to 15 weeks. The degree of skin test reaction for Streptococcus pyogenes was increased in all patients after the treatment. Over 40% tumor regression was noted in 6 out of 9 patients who received intra-tumoral injection of OK-432. Complete regression was noted in one patient. Before treatment, Interleukin-2 (IL-2) and lymphokine-activated killer (LAK) cell activity in peripheral blood lymphocytes decreased in HCC patients. Two of 6 patients showed markedly increased activity of LAK-cells one week after treatment with OK-432. One other patient had moderately increased LAK-cell activity after treatment with OK-432. No increase in LAK-cell activity was seen in 3 patients who received intra-tumoral injection of ethanol. An especially increased response of LAK-cell activity was seen in patients with small-sized HCC (diameter below 5 cm).