Liver cancer treatment with transarterial chemoperfusion (TACP) | 2 sessions | Uniclinic Frankfurt, Germany

The TACP therapy is a method that involves the selective regional application of a chemotherapeutic substance to a tumor. The level of cytostatic drug concentration within the tumor determines the extent of tumor destruction. Before each procedure, patients are informed about the potential risks and side effects of the arterial intervention and the cytostatic drug applications. To reduce acute symptoms during TACP such as upper abdominal pain or nausea, patients are given an opioid and, if needed, glucocorticoids through an intravenous route. The procedure begins with local anesthesia, followed by puncturing the femoral artery using the Seldinger technique. A small 4-F sheath is usually used, and catheterization is conducted using Pigtail, Renegade, Cobra, Sidewinder, and Headhunter catheters. After an exploratory upper abdominal angiography, the catheter is selectively placed in the celiac trunk to ensure chemoperfusion of as much of the tumor tissue as possible. A coaxial tracker catheter is used in our department for a super-selective probing of the tumor-supplying vessels. The chemotherapy drugs mitomycin C and gemcitabine are administered for an hour using a perfusor pump in doses of 8. 5 mg/m2 and 1000 mg/m2 BSA, respectively. After the transarterial chemoperfusion is complete, the catheter and sheath are removed, and the patient is provided with a pressure bandage and monitored for 6 hours. The complete TACP treatment includes angiographically guided chemoperfusion, an MRI follow-up on the same day, and a CT follow-up without contrast agent administration 24 to 48 hours after the procedure. Typically, TACP is performed 2-3 times, four weeks apart.