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Radiation Therapy and Percutaneous Ethanol Injection for the Treatment of Hepatocellular Carcinoma

  • Masao Ohto
  • Masaaki Ebara
  • Masaharu Yoshikawa
  • Kunio Okuda

Abstract

Most hepatocellular carcinomas (HCCs) develop in a liver with cirrhosis, which is unfavorable for surgical treatment. In the Far East, particularly in Japan, cirrhosis is often advanced at the time of tumor detection. The current choice of therapeutic modality is transcatheter arterial embolization (TAE), which, if properly executed in patients with moderately advanced HCC, significantly prolongs survival (Chap. 25). It does not afford complete cure, however. TAE necrotizes the arterial blood-dependent HCC, but cancer cells remain viable in the periphery of an expanding HCC, the most common gross type, and later cause intrahepatic spread.

Keywords

Tumor Thrombus Transcatheter Arterial Embolization Percutaneous Ethanol Injection Hepatic Coma Complete Necrosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Ingold JA, Reed GB, Kaplan HS, Bagshaw MA (1965) Radiation hepatitis. Am J Roentgenol Rad Therapy 93:200–208Google Scholar
  2. 2.
    Johnson PM, Grossman FM, Atkins HL (1967) Radiation induced hepatic injury. Its detection by scintillation scanning. Am J Roentgenol Rad Therapy 99:435–462CrossRefGoogle Scholar
  3. 3.
    Lewin K, Millis RR (1973) Human radiation hepatitis. Arch Pathol 96:21–26PubMedGoogle Scholar
  4. 4.
    Cochrane AMG, Murray-Lyon IM, Brinkley DM, Williams R (1977) Quadruple chemotherapy versus radiotherapy in treatment of primary hepa-tocellular carcinoma. Cancer 40:609–614PubMedCrossRefGoogle Scholar
  5. 5.
    Bhardwaj S, Bruckner HW, Holland JF (1985) Therapy of malignant tumors of the liver. In: Berk JE (ed) Bockus gastroenterology, 4th edn., vol. 5. Saunders, Philadelphia, pp 3388–3397Google Scholar
  6. 6.
    Grady ED, Nolan TR, Crumbley AJ, Larose JH, Cheek WV (1975) Internal hepatic radiotherapy: II. Intra-arterial radiocolloid therapy for hepatic tumors. Am J Roentgenol Rad Therapy 124: 596–599CrossRefGoogle Scholar
  7. 7.
    Grady ED (1979) Internal radiation therapy of hepatic cancer. Dis Col Rect 22:371–375CrossRefGoogle Scholar
  8. 8.
    Order SE, Klein JL, Ettinger D, Alderson P, Siegelman S, Leicher P (1980) Phase I–II study of radiolabeled antibody integrated in the treatment of primary hepatic malignancies. Int J Radiation Oncol Biol Phys 6:703–710CrossRefGoogle Scholar
  9. 9.
    Ettinger DS, Order SE, Wharam MD, Parker MK, Klein JL, Leicher PK (1982) Phase I–II study of isotopic immunoglobulin therapy for primary liver cancer. Cancer Treat Rep 66:289–297PubMedGoogle Scholar
  10. 10.
    Holm HH, Stryer I, Hansen H, Stadil F (1981) Ultrasonically guided percutaneous interstitial implantation of iodine 125 seeds in cancer therapy. Br J Radiol 54:665–670PubMedCrossRefGoogle Scholar
  11. 11.
    Friedman M, Cassidy M, Levine M, Phillips T, Spivack S, Resser KJ (1979) Combined modality therapy of hepatic metastasis. Cancer 44:906–913PubMedCrossRefGoogle Scholar
  12. 12.
    Barone RM, Byfield JE, Frankel S (1979) Combination infusional 5-fluorouracil and radiation therapy for the treatment of metastatic carcinoma of the colon to the liver. Dis Col Rect 22:376–382CrossRefGoogle Scholar
  13. 13.
    Lokich J, Kinsella T, Perri J, Malcolm A, Clouse M (1981) Concomitant hepatic radiation and intraarterial fluorinated pyrimidine therapy. Correlation of liver scan, liver function tests, and plasma CEA with tumor response. Cancer 48: 2569–2574PubMedCrossRefGoogle Scholar
  14. 14.
    Shinagawa T, Ohto M, Kimura K, Tsunetomi S, Morita M, Saisho H, Tsuchiya Y, Saotome N, Karasawa E, Miki M, Ueno T, Okuda K (1984) Diagnosis and clinical features of small hepatocellular carcinoma with emphasis on the utility of real-time ultrasonography. Gastroenterology 86: 495–502PubMedGoogle Scholar
  15. 15.
    Okuda K (1986) Early recognition of hepatocellular carcinoma. Hepatology 6:729–738PubMedCrossRefGoogle Scholar
  16. 16.
    Ohto M, Karasawa E, Tsuchiya Y, Kimura K, Saisho H, Ono T, Okuda K (1980) Ultrasonically guided percutaneous contrast medium injection and aspiration biopsy using a real-time puncture transducer. Radiology 136:171–176PubMedGoogle Scholar
  17. 17.
    El-Domeiri AL, Huvos AG, Goldsmith HS, Foote FW Jr (1971) Primary malignant tumors of the liver. Cancer 27:7–11PubMedCrossRefGoogle Scholar
  18. 18.
    Primack A, Vogel CL, Kyalwazi SK, Ziegler JL, Simon R, Anthony PP (1975) A staging system for hepatocellular carcinoma: Prognostic factors in Ugandan patients. Cancer 35:1357–1364PubMedCrossRefGoogle Scholar
  19. 19.
    Steiner PE (1960) Cancer of the liver and cirrhosis in trans-Saharan Africa and the United States of America. Cancer 13:1085–1166CrossRefGoogle Scholar
  20. 20.
    Okuda K, Peters RL, Simson IW (1985) Gross anatomic features of hepatocellular carcinoma from three disparate geographic areas. Proposal of new classification. Cancer 54:2164–2173Google Scholar
  21. 21.
    Nakashima T, Okuda K, Kojiro M, Jimi A, Yamaguchi R, Sakamoto K, Ikari T (1983) Pathology of hepatocellular carcinoma in Japan. 232 consecutive cases autopsied in ten years. Cancer 51:863–877PubMedCrossRefGoogle Scholar
  22. 22.
    Shinagawa T, Ohto M, Kimura K, Tsunetomi S, Norita M, Saisho H, Tsuchiya Y, Saotome N, Karasawa E, Miki M, Ueno T, Okuda K (1984) Diagnosis and clinical features of small hepatocellular carcinoma with emphasis on the utility of real-time ultrasonography. Gastroenterology 86: 495–502PubMedGoogle Scholar
  23. 23.
    Ebara M, Ohto M, Shinagawa T, Sugiura N, Kimura K, Matsutani S, Morita M, Saisho H, Tsuchiya Y, Okuda K (1986) Natural history of minute hepatocellular carcinoma smaller than three centimenters complicating cirrhosis. A study in 22 patients. Gastroenterology 90:289–298PubMedGoogle Scholar
  24. 24.
    Okuda K (1986) Early recognition of hepatocellular carcinoma. Hepatology 6: 729–738PubMedCrossRefGoogle Scholar

Copyright information

© Springer Japan 1987

Authors and Affiliations

  • Masao Ohto
  • Masaaki Ebara
  • Masaharu Yoshikawa
  • Kunio Okuda
    • 1
  1. 1.First Department of MedicineChiba University School of MedicineInohana, Chiba, 280Japan

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