Transarterial chemoperfusion for liver cancer treatment
What is transarterial chemoperfusion?
Transarterial chemoperfusion (TACP) - is a minimally invasive treatment based on the selective regional use of the chemotherapeutic substance. TACP method allows carrying out a very high dose of chemotherapy to the disease focus.
The principle of TACP is to use different blood supplies tumours in the liver and healthy organ tissues. This treatment method is built on the fact that 75% of healthy liver tissue feeds on venous blood and only 25% of arterial blood. On the contrary, 95% of liver tumours are supplied through the hepatic arteries. The new method of treating liver cancer is effective, safe and aims to improve the quality of life. Furthermore, TACP has minimal side effects.
A detailed description of TACP for liver cancer treatment
Transarterial chemoperfusion delivers high concentrated drugs to the affected tissues of the liver to maximize the therapeutic effect while limiting side effects. Local administration is a distinctive feature of TACP from conventional chemotherapy, in which the drug is administered intravenously and circulates throughout the body.
The transarterial chemoperfusion is usually performed under general anaesthesia. However, it can be done under local anaesthesia as well. The high doses of the chemotherapeutic drug are injected directly into the liver through a catheter. The infusion is performed into the liver artery for about 30 minutes. In addition, the temperature of the chemotherapy used can be increased to 40 - 42°C. High temperature provides more effect on the tumour, and local use minimizes adverse reactions.
During transarterial chemoperfusion, the blood from the liver passes through the filtration system. As a result, most chemotherapeutic drugs are removed before the blood is returned to the bloodstream through a catheter in the inner jugular vein.
After completing the transarterial chemoperfusion (TACP), the doctor removes the catheter, applies a pressure bandage to the groin and observes the patient. Treatment is usually carried out 1-2 times at an individual interval.
Advantages of the treatment
The procedure is similar to other intraarterial methods of liver cancer treatment, such as transarterial chemoembolization (TACE). These methods use the difference in blood supply in the tumour liver and normal tissue. The main difference between the TACP method is continuous and isolated chemotherapy.
Advantages of liver cancer treatment by transarterial chemoperfusion:
- delivery of a highly controlled dose of chemotherapy directly to the foci of the liver tumour;
- the possibility of a simultaneous impact on all foci in the liver;
- significant decrease in tumour growth/decrease of the tumour until complete disappearance;
- low effect on the body due to local application;
- absence of significant complications;
- the method improves quality and prolongs life in severe cases;
- a short hospitalization time;
- no surgical incision is required (minimally-invasive procedure);
- the ability to combine with other methods to enhance the effect.
Results and statistics
Treatment of oncology by transarterial chemoperfusion (TACR) is a new and successful treatment for advanced liver cancer. It significantly improves the quality of life. TACP method is safe and highly effective and can be applied considering the available data about the patient.
According to a recent study conducted by the American Association for the Study of Liver Diseases (AASLD), the effectiveness of TACP was analyzed compared to supportive therapy in patients with liver metastases. Both groups were well balanced. The overall survival rate of these studies confirmed the advantage of TACP. Two-year survival after TACP was 19.9% against 4.8% when using maintenance therapy.
- Іnterventional news: Transarterial chemoperfusion is safe and feasible in advanced mesothelioma
- Karger: Arterial therapy for non-colorectal liver metastases
- Baylor College of Medicine®: Healthcare: Cancer Care
- Research Gate: Chemoocclusion vs chemoperfusion for treatment of advanced hepatocellular carcinoma: A randomised trial
- Georg Thieme Verlag KG: Transarterielle Chemoperfusion mit Gemcitabine und Mitomycin C bei Pankreaskarzinom: Ergebnisse bei Rezidivtumoren und fortgeschrittenen Tumorstadien
- Rsna Radiology: Nonselective Transarterial Chemoperfusion: A Palliative Treatment for Malignant Pleural Mesothelioma