Issn Print: 1742-8009

Publication Date: 2005/06/01


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Chemoembolisation promoted as first-line therapy for inoperable liver cancer

Peggy Peck

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Excerpt

Dr Jeff Geschwind is an interventional radiologist with a mission: to convince all medical oncologists that chemoembolisation should be ‘standard first-line treatment for inoperable liver tumours’. And he says that he and his Johns Hopkins colleagues have the data to make that mission a success.
In a highlighted scientific presentation in New Orleans at the Society of Interventional Radiology's 30th Annual Meeting, Dr Geschwind reported that 70% of 149 patients treated with transcatheter chemoembolisation (TACE) had no toxicities associated with the treatment.
That was true even though the lesions were treated with a combination of cisplatin, doxorubicin, and mitomycin C, a regimen that would have significant toxicity if delivered systemically.
The drugs are mixed in an emulsion of ethiodol oil and delivered by catheter to the tumour site, and then the hepatic artery is occluded by injecting tiny pellets - 300 to 500 micron embospheres - into it. These spheres expand and squeeze off the blood flow in much the same way that a tap will control the flow of water.
The technique, Dr Geschwind said, has been successful ‘even in the presence of portal vein occlusion’.
‘Chemoembolisation is a unique therapy that marries catheters with drug delivery in a way that an effective dose is delivered directly to the tumour, while preserving healthy tissue’
The embolisation does not ‘cut off the blood supply to the tumour, it just slows the blood flow to the liver,’ he explained.

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