New research by Jeff Geschwind, M.D., director of interventional radiology and associate professor at Johns Hopkins University School of Medicine, has shown that liver cancer patients, most of whom have inoperable tumours, could benefit from chemoembolization, a nonsurgical treatment option that delivers a high-dose of chemotherapy to the tumour while decreasing blood flow through the arteries feeding the tumour, known as embolization.
By reducing blood flow to the tumour, the embolic agent allows the chemotherapeutic drugs to remain localized to the tumour, decreasing harm to healthy tissues and allowing higher doses of the drugs to be used.
Two studies found that chemoembolization does not induce liver toxicity and can possibly offer patients additional months, and is safe for high-risk liver cancer patients who already have restricted blood flow in the liver due to portal vein thrombosis.
Geschwind says a safety study demonstrated that chemoembolization should be the standard first-line treatment for inoperable liver tumours because patients have minimal procedural toxicity and it is already proven to substantially increase survival.
The best chance for a cure is of course the surgical removal of liver tumours but unfortunately liver tumours are often inoperable because they may be too large, or have grown into major blood vessels or other vital structures and sometimes, many small tumours are spread throughout the liver, making surgery too risky or impractical. Surgical removal is usually only possible for one third of primary liver cancer patients and 90 percent of patients with metastatic (secondary) liver cancer. The patients' compromised liver function means that doctors must be careful that cancer treatments do not cause additional liver damage and toxicity, which could lead to death.
Chemoembolization usually involves a hospital stay of two to four days and is a recognized palliative treatment for unresectable tumours.
Geschwind says that chemoembolization offers patients a nonsurgical option that preserves healthy tissue, is well tolerated and has a short recovery time and it can be repeated to control tumour growth or progression, thereby extending life expectancy in the majority of cases.