Chemo Infusion and Chemoembolization of Liver (cont.)
What about mixing the chemotherapy with lipiodol?
In Japan, the chemotherapeutic agents are mixed with lipiodol. The idea is
that since the tumor cells preferentially take up lipiodol, they would likewise
take up the chemotherapy. This Japanese technique has not yet been validated in
head-to-head comparisons with conventional TACE.
What are the benefits of TACE?
In one large study involving several institutions in Italy, chemoembolization
did not seem to be beneficial. Patients who did not undergo TACE lived as long
as patients who received TACE, even though the tumors were more likely to shrink
in size in patients who were treated. Does this mean that TACE or intra-arterial
chemotherapy does not work? Maybe, maybe not.
Studies in Japan, however, have shown that TACE can downstage HCC. In other
words, the tumors shrank enough to lower (improve) the stage of the cancer. From
the practical point of view, shrinking the tumor creates the option for surgery
in some of these patients. Otherwise, these patients had tumors that were not
operable (eligible for operation) because of the initial large size of their
tumors. More importantly, these same studies showed an improvement in survival
in patients whose tumors became considerably smaller. In the U.S., trials are
underway to see whether doing TACE before liver transplantation increases
patient survival as compared to liver transplantation without TACE.
It is safe to say that TACE or intra-arterial
chemoinfusion are palliative treatment options for HCC. This means that these procedures
can provide relief or make the disease less severe. However, they are not curative
(do not result in a cure). Fewer than 50% of patients will have some shrinkage
in tumor size. Further, they can be used only in patients with
relatively preserved liver function. The reason for this is that these procedures
can lead to liver failure in individuals with poor liver function.
To read more about Hepatocellular Carcinoma (HCC), please read the
MedicineNet.com Liver Cancer (Hepatocellular Carcinoma)
article.
Last Editorial Review: 5/2/2007
- Chemotherapy - Explains chemotherapy, a drug treatment to kill cancer cells. Article includes descriptions, uses, and side effects, and care support.
- Liver Cancer - Get information on liver cancer, its symptoms, causes, diagnosis, staging, prognosis, treatment, and prevention.
- The Digestive System - Read about the digestive system from chewing food, swallowing, emptying into the stomach, through the small and large intestines, and then expelling waste through the anus.
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