Chemoembolization is a minimally invasive, targeted cancer treatment that combines chemotherapy and embolization to deliver high concentrations of cancer-fighting drugs directly to a tumor while also blocking its blood supply. This procedure is primarily used to treat liver cancers, such as hepatocellular carcinoma, and certain metastatic liver tumors from other primary cancers like colorectal cancer.

Indications for Chemoembolization:

  1. Unresectable primary liver cancer (hepatocellular carcinoma) or liver-dominant metastatic disease from other primary cancers.
  2. Patients who are not candidates for surgery, liver transplantation, or other local treatments like ablation.
  3. Bridge therapy to liver transplantation to control tumor growth before the transplant.
  4. Palliative treatment to manage symptoms and improve the quality of life for patients with advanced liver cancer.

Procedure:

An interventional radiologist performs chemoembolization under local anesthesia and conscious sedation. The steps include:

  1. A small incision is made in the groin area to access the femoral artery.
  2. Using fluoroscopic (real-time X-ray) guidance, a catheter is advanced through the arterial system to the hepatic artery supplying the tumor.
  3. A combination of chemotherapy drugs and embolic agents (such as small particles or beads) is delivered directly into the tumor’s blood supply through the catheter.
  4. The embolic agents block the blood vessels, trapping the chemotherapy drugs within the tumor and depriving it of oxygen and nutrients, leading to tumor cell death.

Outcomes:

Chemoembolization has shown promising results in treating liver cancers, including:

  1. Improved survival rates and tumor response compared to systemic chemotherapy for unresectable hepatocellular carcinoma.
  2. Tumor shrinkage or growth delay, potentially making patients eligible for surgery or other treatments.
  3. Symptom relief and improved quality of life for patients with advanced liver cancer.
  4. Reduced side effects compared to systemic chemotherapy, as the drugs are delivered directly to the tumor and have limited impact on healthy tissue.

However, it’s important to note that outcomes can vary depending on factors like tumor type, size, location, and overall patient health. Chemoembolization may also be combined with other treatments like surgery, radiation therapy, or targeted therapies for a comprehensive cancer treatment plan.

As with any medical procedure, chemoembolization has potential risks and side effects, such as post-embolization syndrome (fever, nausea, pain), infection, or damage to surrounding tissue. It’s crucial to discuss the potential benefits and risks with an interventional radiologist and oncologist to determine if chemoembolization is appropriate for a specific case.