Chemoembolization
Patient
Selection Criteria
Chemoembolization is used most often in unresectable patients with tumors
confined to the liver. Patients with severe hepatic dysfunction, compromised
portal venous (liver vein) blood flow and/or biliary obstruction are
not candidates.
Description
of Procedure
This is
a minimally invasive procedure, usually done in the interventional radiology
department. General anesthesia is not required. The arteries supplying
the tumor with blood are identified and a catheter is positioned into
those selected vessels. An embolic agent is mixed with chemotherapeutic
agent(s) and then infused through the catheter to the tumor site. The
embolic agent is used to cut off the blood supply of the tumor (embolizing)
so that the chemotherapy stays within the tumor area.
The success
of the embolization is initially established by using contrast dye to
confirm that blood flow to the tumor has been cut off (ischemia), while
flow to normal arteries is preserved.
Risks/Side
Effects/Complications
The 30-day
mortality rate for chemoembolization ranges from 1 to 4%.
The most
common complications for chemoembolization are:
- Nausea
- Abdominal
pain
- Vomiting
- Fever
greater than 39 degrees C (102.2 degrees F)
Less common
complications include, but are not limited to:
- Anorexia
- Diarrhea
- Hematoma
- Transient
renal insufficiency
- Transient
encephalopathy
- Ulnar
neuropathy
- Ascites
- Hepatic
failure
- Hepatic
infarction
- Biliary
necrosis
- Hepatic
abscess
- Tumor
rupture
- Surgical
cholecystitis
- Embolism
to the gut
Recovery
Time/ Lifestyle Changes
The average
length of hospital stay for chemoembolization is 1.5 days. If there
are many tumors or the tumors are large, multiple treatments will have
to be done, requiring the patient return for subsequent treatments one
to four times after the initial treatment.
Effectiveness
Survival
rates vary widely with this procedure. Studies have reported survival
rates ranging from 35-88% for 1 year, 20-64% for 2 years, and 11-51%
for 3 years. Median survival is less than 10 months. Several studies
show no survival benefit of chemoembolization over embolization alone.
©
2001 RITA Medical Systems, Inc. | Contact Us | Disclaimer |Last modified: Friday, October 10, 2003
