[Combined treatment of hepatic carcinoma: percutaneous intratumoral injection of Y-90 glass treatment microspheres with sonographic guidance].

Twenty-eight patients with hepatic carcinoma were treated with a percutaneous injection of Y-90 glass treatment microspheres (GTMS) with sonographic guidance. Of these patients, some were also given alcohol around the lesions and intraportal vein chemotherapy alternatively. Diagnoses were confirmed by biopsy in all patients preoperatively. All patients were alive after 2-16 months follow up. In this group, 91% patients had their tumor size reduced. All lesions showed changes in echo pattern on US scans after the treatment, most of them being hyperechogenic, then being mixed echogenic or isoechogenic. Blood flow sign decreased within lesions and at periphery on color Doppler scans. Of the 13 patients with increased AFP level before injection, 11 had AFP titer dropped with 6 falling to normal after treatment. All patients experienced relief of symptoms and improved general conditions. Histopathologic examination performed in 8 patients after treatment showed complete necrosis and fibrosis of the tumor in 7. Small focus of tumor tissue was detected in one patient only. The therapeutic outcome indicated that the percutaneous intratumoral injection of Y-90 is an appropriate first-line treatment for patients with hepatic carcinoma.