肝硬変・肝細胞癌治療の補助的手段としての部分的脾動脈塞栓療法の有用性

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  • Usefulness of partial splenic embolization as auxiliary treatment for liver cirrhosis and hepatocellular carcinoma

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Patients with thrombocytopenia associated with chronic hepatitis or liver cirrhosis (LC) are sometimes difficult to treat with interferon (IFN) therapy. Chemotherapy for advanced hepatocellular carcinoma (HCC) does not always produce expected therapeutic effects, because it reduces blood cell counts, and makes it difficult to continue the treatment of HCC. In this study, we evaluated the usefulness of partial splenic embolization (PSE) as an auxiliary treatment for LC and HCC. The subjects were 61 patients who underwent PSE, consisting of 32, 14, and 17 treated with either of IFN, radiofrequency ablation (RFA), and continuous hepatic artery infusion (HAI), respectively. Platelet counts were significantly elevated 1 year after PSE. Albumin and cholesterol levels also rose after 1 year, suggesting that PSE improves liver function. The SVR rate in IFN-treated patients who received PSE was 36.4%, and that in those with a 1b high virus titer was 25%. Splenic abscess developed in 1 patient as a serious complication. In advanced HCC patients with a platelet count of less than 7×104/μl, a combination of PSE and HAI improved the prognosis. These results suggest that PSE is useful as an auxiliary treatment for LC and advanced HCC.

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