Chemoembolization for Liver Cancer

Two-thirds of liver cancer patients have inoperable tumors and could benefit from a nonsurgical treatment option that delivers a high dose of chemotherapy to a tumor while decreasing blood flow through the arteries feeding the tumor, according to the results of several new studies.

Called chemoembolization, this option allows chemotherapeutic drugs to remain localized to the tumor, decreasing harm to healthy tissues and allowing higher doses of the drugs to be used. Chemoembolization does not induce liver toxicity, the studies showed, but offers patients additional months, and is even safe for high-risk liver cancer patients who already have restricted blood flow in the liver due to portal vein thrombosis.

Although surgical removal of liver tumors offers the best chance for a cure, many are inoperable because they are too large or have grown into major blood vessels or other vital structures. Sometimes, many small tumors are spread throughout the liver, making surgery too risky or impractical. More than two-thirds of liver cancer patients and 90% of those with metastatic cancer cannot have surgery. Doctors need to ensure that cancer treatments do not cause additional liver damage and toxicity.

In chemoembolization, a doctor threads a tiny catheter up the femoral artery in the groin into the blood vessels supplying the liver tumor. The embolic agents keep the chemotherapy drug localized to the tumor while depriving the tumor of blood needed for its growth. The procedure usually involves a hospital stay of two to four days.

"The safety study shows that chemoembolization should be the standard first-line treatment for inoperable liver tumors,” noted Jeff. Geschwind, M.D., director of interventional radiology and associate professor at Johns Hopkins University School of Medicine (Baltimore, MD, USA).




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Johns Hopkins School of Medicine